scholarly journals Evaluation of the use of Hypertonic Saline 3% Nebulizer versus Intravenous Hypertonic Saline 3% to Attenuate the Manifestations of Acute Respiratory Distress Syndrome

2020 ◽  
Vol 14 (1) ◽  
pp. 52-61
Author(s):  
Amr Sobhy ◽  
Abdelkarem Hussiny ◽  
Mohammed Kamal

Background: A well-known disease, Acute Respiratory Distress Syndrome (ARDS) presents a daunting challenge to the medical community with alarmingly high mortality rates. Initiation of hypertonic saline (HTS) nebulization therapy for patients with early ARDS appears to be tolerable and may be beneficial. However, using a nebulizer is cumbersome and less efficient. This study aims to assess the efficacy of using HTS3% in a nebulizer in comparison with intravenously injecting it to attenuate the manifestation of ARDS. The study analyses factors such as the severity of the disease, need and duration of mechanical ventilation (MV), ICU stay, and mortality rate in the comparative analysis. Materials and Methods: The randomized, comparative, and controlled study included patients of both genders from an age bracket of 18-60 years. The patients fulfilled the Berlin definition of ARDS. Additionally, the whole sample was divided into four groups (26 patients each): Group A received standard pharmacotherapy [methylprednisolone 1mg/kg/day intravenously and salbutamol nebulizer 2.5 mg (1 ml) + 3 ml normal saline/8hr] and normal saline 0.9% (5ml) nebulizer /8hr: Group B received standard pharmacotherapy + HTS2.7% (5ml) nebulizer/8hr: Group C also received standard pharmacotherapy and 500ml normal saline intravenously over 24 hours: Group D received standard pharmacotherapy and 500 ml HTS 3% intravenously over 24 hours. The following parameters were recorded: Lung injury score (Murray Score, calculated every 24 hours), the incidence of the need for MV, duration of MV, length of ICU stay, and mortality rate. Results: Group B (HTS nebulizer group) and group D (HTS IV group) showed the most rapid improvement in the Murray score with a 50% decrease in the score from its initial value (D50%) by day 4 with P-values of 0.013 and 0.022 respectively. Subjects from Group D (HTS IV) and Group B (HTS Nebulizer) were the least in need of MV as only 38.5% needed MV with a P-value <0.001. In comparison, 69.2% subjects from group A (control) and 73.1% from group C required MV, with a P-value <0.001. The shortest duration of MV care was found in group D (median 3.12 days), followed by group B (median 4.21 days). The results were highly significant, with P-value 0.004 when compared with group A (control group) and group C. In addition, the longest duration of MV care was reported in group A (median 5.37 days). There was significant variation in all groups regarding the length of ICU stay: group D required the least number of days (median 6.76 days), followed by group B (median 7.08 days). The result was statistically significant, with a P-value of 0.004 when compared with the control group (median 9.1 days) and group C(longest duration of MV with a median of 10.13 days). However, no significant difference was found in the mortality rate (P-value >0.05). Conclusion: The use of hypertonic saline 3% intravenously has a comparable effect as the use of hypertonic saline 3% via nebulizer to attenuate the manifestations of (ARDS) and even superior in the mechanically ventilated patient.

2019 ◽  
Vol 22 (1) ◽  
pp. 73-78
Author(s):  
Farhana Sabrin ◽  
AF Mohammed Shafiqul Alam ◽  
Muhammad Rashedul Islam ◽  
Md Elias Al Mamun ◽  
Jakir Ahmed Chowdhury

The effect of aqueous extract of Basella alba (puishak) leaves on blood cell count of rats was studied. Forty rats of both sexes weighing between 100-150 gm were used. The rats were divided into four groups (7 rats in each group), with group A as the control group and experimental groups were denoted as B, C and D. With all aseptic precautions, aqueous extract of Basella alba (Puishak) leaves was administered into the three different doses (For group B: 60 mg/kg bw, group C: 80 mg/kg bw and group D: 100 mg/kg bw). Control group A also received distilled water as a placebo at the dose of 10 mg/kg bw for 14 days. At day 15, blood samples were collected and sent for haematological analysis. Data analysis of blood count profile of 28 rats revealed that there is an increased number of RBC, WBC and platelet count in experimental groups than in control group. ANOVA test revealed that increased blood cell counts following administration of aqueous leaves extract of keeves of B. alba were statistically significant (p value for each case was .0001<.05) than control group. Paired samples t test was performed to compare between baseline hematological parameters and parameters after 14 days of intervention. Then comparison between Group A & Group B, between Group A & Group C and between Group A & Group D were done. In all cases, probability (p) value < 0.05 was considered as statistically significant.This it is clearly evident that aqueous extract of B.alba has positive stimulant effect on blood cells count of rats. Moreover, it was found that increment of doses also increases the cell count that is positively correlated with the hypothesis. Bangladesh Pharmaceutical Journal 22(1): 73-78, 2019


2019 ◽  
Vol 8 (3) ◽  
pp. 146-150 ◽  
Author(s):  
Muhammad Imran Shehzad ◽  
Muhammad Atiq Ul Mannan ◽  
Masood Alam ◽  
Abdul Rauf ◽  
Muhammad Imran Sharif

Background: N-Acetylcysteine and 3% hypertonic saline are being used effectively for sputum clearance in chronic cases of bronchiectasis for quite some time. However, their use in acute condition of the disease seems to be underexplored. The objective of our study is to compare the role of nebulized N-acetylcysteine and 3% hypertonic saline in clearing the airway in patients with acute exacerbation of bronchiectasis. Material and Methods: A total of 136 confirmed cases of bronchiectasis were enrolled in this study. This randomized controlled trial was done in chest ward of Nishtar Hospital Multan from January 2015 to March 2017. Sampling was done by non-probability consecutive sampling and patients were divided into two groups A and B by lottery method. Verbal informed consent was taken from all participants. Group A participants received nebulization of N acetylcysteine mixed in normal saline for ten minutes, while group B participants were nebulized with 10ml of 3% hypertonic saline for ten minutes. Group B was active control group in the study. Data was collected on pre-designed Proforma, and analyzed by SPSS version 22. Numerical variables such as saturation, weight of sputum, age and blood pressure was analyzed by using t test. These were considered significant if the p value was equal or less than 0 .05. For qualitative variables chi square test was applied. Results: The mean O2 saturation of Group A, before and after treatment, was 92.11±3.07% and 94.47±2.18%, respectively. The difference was statistically significant (p value =0.001). The sputum weight of Group A, before and after treatment, was 2.63±2.39 g and 7.41±1.38 g, respectively. The difference was statistically significant (p value =0.001). The frequency of rhonchi of Group A, before and after treatment, was 52% and 76%, respectively. The difference was statistically significant (p value =0.003). While, for Group B, the mean O2 saturation, before and after treatment, was 92.36±3.13% and 93.49±2.27%, respectively. The difference was statistically significant (p value =0.012). The sputum weight, before and after treatment, was 3.11±2.01 g and 5.56±1.02 g, respectively. The frequency of rhonchi, before and after treatment, was 45% and 74% respectively. Again, the difference was statistically significant. Conclusion: Both nebulized N-acetylcysteine and 3% hypertonic saline cause airway clearance by enhancing sputum expectoration in patients with acute exacerbation of bronchiectasis equally. Both these agents also improve oxygen saturation in acute exacerbation of bronchiectasis significantly.


2020 ◽  
Vol 27 (01) ◽  
pp. 185-190
Author(s):  
Hamid Raza ◽  
Maqsood Ahmed Siddiqui ◽  
Ahmed Uddin Soomro ◽  
Kamlaish

Objectives: The aim of our study is to observe the pain difference as experienced by the pediatric patient when administered different preparations of propofol utilizing the verbal rating scale. Study Design: Prospective double-blind randomized control trial. Setting: A large tertiary care hospital in Karachi, Pakistan. Period: 6 months from June 2016 to November 2016. Material & Methods: The final patient population included in the study was n= 180 and were divided into six groups. These patients received general anesthesia and underwent surgery. Patients in Group A received 2ml of normal saline and a mixture of propofol and normal saline after waiting for half a minute. Group B patients received 0.5mg/kg Lidocaine followed by normal saline after waiting for half a minute. Group C received 2ml of normal saline followed by a mixture of propofol and Lidocaine after half a minute. Group D received 0.2mg/kg of Ketamine followed by a mixture of normal saline and propofol. Group E patients received 2ml of normal saline followed by a mixture of propofol and Ketamine half a minute later. And finally, patients belonging to group F received 2ml of normal saline followed by a mixture of propofol M/LCT and normal saline half a minute later respectively. Results: The gender, age, body weight and ASA grade of all the pediatric patients were similar having a P value of >0.05. The incidence rate of propofol injection pain in the groups were found to be Group A= 76.66%, Group B= 66.66%, Group C= 50%, Group D= 60%, Group E= 63.33%, Group F= 60% respectively. The incidence rate for adverse events was significantly lower in all the groups as compared to Group A that is the normal saline and propofol group having a p-value of less than 0.01. And the incidence rate of adverse events was lower in Groups C, D, E, and F were significantly lower than Group B having a p-value of less than 0.05. All the experimental groups had significantly lower scores of the VRS scale as compared to the control group (Group A) and the intergroup differences were found to be statistically significant having a p-value of less than 0.01. Conclusion: In our study, we found that the injection pain of propofol administration in the pediatric population was significantly reduced when using M/LCT pre-injection, 0.5mg/kg lidocaine or 0.2mg/kg of Ketamine. Another good combination is mixing 180mg propofol with 40mg of lidocaine or mixing propofol with 16mg of Ketamine.


2019 ◽  
Vol 26 (05) ◽  
Author(s):  
Saima Qureshi ◽  
Khadija Qamar ◽  
Tassaduq Hussain

Objectives: To observe the effect of lagenaria siceraria on inflammation and fibrosis brought about by arsenic in liver of Sprague Dawley rat. Study Design: Laboratory based randomized control trial. Place and Duration of Study: This experiment was performed at Department of Anatomy, Army Medical College Rawalpindi in co-operation with National Institute of Health (NIH) Islamabad for eight weeks (1st March 2017 to 25th April 2017). Material and Methods: Fifty Sprague Dawley rats (both male and females housed separately) were carefully chosen and distributed randomly into five groups, each consisting of 10 animals. A and B were the control groups whereas C, D and E served as experimental groups. During the first four weeks, experiment groups C, D and E were given a dosage of 5milligram/kilogram body weight of sodium arsenite. At the end of four weeks, animals from control group A and experimental group C were dissected and liver samples were processed for microscopic studies. In the next 4 weeks, group D animals were set aside without any further intervention. At that time, sodium arsenite at a dose of 5 milligram/kilogram body weight and lagenaria siceraria at a dose of 100 milligram/kilogram bodyweight were administered to group E animals. Group B animals served as control for experimental groups D and E. At the end of these 4 weeks animals of groups B, D and E were dissected. Liver was processed, fixed and stained for microscopic study. Area of portal triad as well as liver lobules were studied for inflammation and fibrosis and results were analysed. Statistical tool used to analyse the data was SPSS v 22. Results were considered to be significant when p-value is ≤ 0.05. Results: Experimental group C developed moderate grade fibrosis and inflammation (grade 2 to 3) as compared to group A. Degree of inflammation and fibrosis was mild to moderate (grade 1 to 2) in group D. There was no inflammation and fibrosis (Grade 0 to 1) in group E. Group B served as a control for group D and E. Conclusion: Inflammation and fibrosis developed in the liver of adult rats when they were subjected to sodium arsenite even for a brief calculated period. Simultaneous administration of lagenaria siceraria can shield and diminish the toxic effects of arsenic. Oxidative potential and immunomodulatory properties and presence of flavonoid like substances renders lagenaria siceraria to act as ameliorative against this fibrosis and inflammation in liver lobules and surrounding area of portal triads.


2021 ◽  
Vol 15 (9) ◽  
pp. 2867-2869
Author(s):  
Asma Arshad ◽  
Saira Munawar ◽  
Rabia Sajjad Toor ◽  
Saba Saleem ◽  
Kanwal Sharif ◽  
...  

Objective: The main purpose of this study is to evaluate the hepatoprotective effects of propolis in hepatocytes injury caused by ATT due to isoniazid and rifampicin. Methods: Healthy albino rats of with average weight of 200-250g were under this study. These rats dividing into main four groups, A group is taken a control group and then further into the group B, group C, and group D as group for experiments. The control group had 15 rats with measured weight, they were given distilled water. Group B had 15 rats, they were given with standard dose of rifampicin and isoniazid. Group c had 15 rats, they were also given with standard dose of rifampicin and isoniazid. Group D had 15 rats, they were given with standard dose of rifampicin and isoniazid and also extract of the propolis we prepared. Results: Serum ALT in the experimental group B with group C, group D were also found to be of statistically significant with p-value < 0.001. ALT serum level observed high in group B. Multiple comparison between groups revealed that group B with a significantly increase in the serum enzyme AST level in comparison to group A, group C and group D with p-value <0.001. Conclusion: This study showed that ethanolic extract of propolis prevents isoniazid and rifampicin induced hepatotoxicity in the albino rats. Key words; Propolis, Anti-tuberculosis treatment, Hepato-toxicity.


2015 ◽  
Vol 35 (4) ◽  
pp. 398-403 ◽  
Author(s):  
Y Alcaraz-Contreras ◽  
RP Mendoza-Lozano ◽  
ER Martínez-Alcaraz ◽  
M Martínez-Alfaro ◽  
MA Gallegos-Corona ◽  
...  

We studied the effect of silymarin and dimercaptosuccinic acid (DMSA), a chelating agent that was administered individually or in combination against lead (Pb) toxicity in rats. Wistar rats (200 ± 20) were randomly divided into five groups. Group A served as a control. Groups B–E were exposed to 2000 ppm of lead acetate in drinking water for 8 weeks. Group B served as a positive control. Group C received silymarin (100 mg kg−1 orally) for 8 weeks. Group D received DMSA (75 mg kg−1 orally) once daily for the last 5 days of treatment. Group E received DMSA and silymarin as groups C and D, respectively. The effect of Pb was evaluated and accordingly the treatments on blood lead levels (BLLs), renal system, and genotoxic effects were calculated using comet assay. The BLLs were significantly increased following the exposition of lead acetate. The administration of silymarin and DMSA provided reduction in BLLs. Silymarin and DMSA provided significant protection on the genotoxic effect of Pb. The toxic effect of Pb on kidneys was also studied. Our data suggest that silymarin and DMSA improve the renal histopathological lesions.


Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.


2021 ◽  
Vol 10 (2) ◽  
pp. 024-030
Author(s):  
Godwin Chinedu Uloneme ◽  
Demian Nnabuihe Ezejindu ◽  
Darlington Cyprian Akukwu ◽  
Amadi Chibundu Chiekezie

Background: The extract of Corchorus olitorius has a reasonable content of vitamins A and C, calcium, iron and fibre, and therefore enjoys a universal application in the treatment of some disease conditions, even as the whole leaf is a very important component of food in so many cultures. Purpose: The study was designed to investigate the effect of Corchorus olitorius extracts on the testis of adult Wistar rats. Method: A total number of thirty two adult Wistar rats weighing between 180 and 200 grammes separated into four groups labeled A,B,C and D respectively were used for the study. Animals in group A which served as the control group were fed with the normal rat chow and water only. The group B rats were administered 100mg/kg body weight of aqueous extract of Corchorus olitorus; while those in group C were administered 500mg/kg body weight of the extract. The group D rats received 1000mg/kg body weight of the extract. For a period of four weeks, the different experimental animal groups received the respective aforementioned treatments once daily, around nine- o’clock in the morning through oral intubation. At the end of the 28 day treatment, the animals were sacrificed and the testes harvested for histological, investigation, and through cardiac puncture, blood samples for some hormonal studies was also collected and investigated using standard laboratory standards. Results: Observations made showed that the extract produced no histological distortions, degenerative or defective effects on the testicular tissues. The testosterone levels of group B, C, and D rats were observed to be significantly higher (P<0.005) than that of the group A (control group).ound: The extract of Corchorus olitorius has a reasonable content of vitamins A and C, calcium, iron and fibre, and therefore enjoys a universal application in the treatment of some disease conditions, even as the whole leaf is a very important component of food in so many cultures. Purpose: The study was designed to investigate the effect of Corchorus olitorius extracts on the testis of adult Wistar rats. Method: A total number of thirty two adult Wistar rats weighing between 180 and 200 grammes separated into four groups labeled A,B,C and D respectively were used for the study. Animals in group A which served as the control group were fed with the normal rat chow and water only. The group B rats were administered 100mg/kg body weight of aqueous extract of Corchorus olitorus; while those in group C were administered 500mg/kg body weight of the extract. The group D rats received 1000mg/kg body weight of the extract. For a period of four weeks, the different experimental animal groups received the respective aforementioned treatments once daily, around nine- o’clock in the morning through oral intubation. At the end of the 28 day treatment, the animals were sacrificed and the testes harvested for histological, investigation, and through cardiac puncture, blood samples for some hormonal studies was also collected and investigated using standard laboratory standards. Results: Observations made showed that the extract produced no histological distortions, degenerative or defective effects on the testicular tissues. The testosterone levels of group B, C, and D rats were observed to be significantly higher (P<0.005) than that of the group A (control group).


2021 ◽  
Vol 14 (10) ◽  
pp. 1508-1517
Author(s):  
Shan-Na Chen ◽  
◽  
Ying-Xue Ma ◽  
Song Chen ◽  
Guang-Hui He ◽  
...  

AIM: To investigate the protective effect of human umbilical cord mesenchymal stem cells (hUCMSCs) modified by the LIF gene on the retinal function of diabetic model rats and preliminarily explore the possible mechanism. METHODS: A stably transfected cell line of hUCMSCs overexpressing leukemia inhibitory factor (LIF) was constructed. Overexpression was verified by fluorescent quantitative polymerase chain reaction (qPCR). Forty-eight adult Sprague-Dawley rats were randomly divided into a normal control group (group A), streptozotocin-induced diabetic control group (group B), diabetic rats at 3mo injected with empty vector-transfected hUCMSCs (group C) or injected with LIF-hUCMSCs (group D). Four weeks after the intravitreal injection, analyses in all groups included retinal function using flash electroretinogram (F-ERG), retinal blood vessel examination of retinal flat mounts perfused with fluorescein isothiocyanate-dextran (FITC-dextran), and retinal structure examination of sections using hematoxylin and eosin staining. Expression levels of adiponectin (APN), high-sensitivity C-reactive protein (hs-CRP), and neurotrophin-4 (NT-4) in each group was detected using immunohistochemistry, PCR, Western blotting, and ELISA, respectively. RESULTS: A stable transgenic cell line of LIF-hUCMSCs was constructed. F-ERG and FITC-dextran examinations revealed no abnormalities of retinal structure and function in group A, severe damage of the retinal blood vessels and function in group B, and improved retinal structure and function in group C and especially group D. qPCR, ELISA, and Western blot analyses revealed progressively higher APN and NT-4 expression levels in groups B, C, and D than in group A. hs-CRP expression was significantly higher in group B than in groups A, C, and D, and was significantly higher in group C than in group D (P<0.05). CONCLUSION: LIF-hUCMSCs protect the retina of diabetic rats by upregulating APN and NT-4 expression and downregulating hs-CRP expression in the retina.


2020 ◽  
Author(s):  
Obeagu Emmanuel Ifeanyi

The hematological features of Gongronema latifolium, aqueous leaves extract was evaluated using standard methods. After 10 days of consecutive infusions into 9 experimental animals (rabbits). The rabbits were monitored and the following parameters determined; hemoglobin (HB), PCV, Platelet, WBC, Differential White Blood Cell. The Rabbits were grouped into 4, one consisting of control (group A), group B was fed with 0.5 mg/kg, group C with 1.0 mg/kg, and Group D with 1.5mg/kg of the aqueous extract of Gongronemalatifolium. The mean values obtained for hemoglobin estimation for the control group is 5.9 ± 4.1 g/dl, 9.1 ± 2.9 g/dl for group B 10.2 ± 1.8 g/dl for group C and 12.8 ± 0.1 g/dl for group D with no significant increase on the PCV estimation, the mean value for the control (group A) is 17.7 ± 12.3%, 27.3 ± 8.7% for group B, group C (30.6 ± 5.4%) and D (28.4 ± 0.3) show increase that statistically significant (p > 0.01). the platelet counts of group C (600 ± 0 x 109/L) and D(600 ± 0 x 109/L) show significant increase (p > 0.01) when compared with the control (600 ± 00). But the platelet value of group B (550 ± 50 x 109/L) shows no difference. No significant changes were observed in the White Blood Counts of the test groups B (3.5 ± 0.5 x 109/L), C (1.9 + 2.1 x 109/L) and D(3.6 ± 0.4) when compared with the control group (2.9 ± 1.9). The values obtained from the differential White Blood Counts (Neutrophils, Lymphocytes, Eosinophils and Monocytes) were not significant. Therefore, Gongronemalatifolium, when properly taken as a nutritional diet, causes beneficial changes on hemoglobin, packed cell volumes and platelet counts of consumers.


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