Biofeedback flutter device for managing the symptoms of patients with COPD

2020 ◽  
Vol 28 (5) ◽  
pp. 477-485
Author(s):  
Rekha Kaja ◽  
Anandh Vaiyapuri ◽  
Mohamed Sherif Sirajudeen ◽  
Hariraja Muthusamy ◽  
Radhakrishnan Unnikrishnan ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Chronic Obstructive ◽  
Post Intervention ◽  
Oxygen Saturation Level ◽  
Chronic Obstructive Pulmonary Diseases ◽  
Before And After ◽  
Group A ◽  
Dyspnea Score ◽  
Group B ◽  
Group D

BACKGROUND: Flutter is a device used in removing excess lung secretions. The conventional flutter lacks a biofeedback component to facilitate optimal use by the patients. OBJECTIVE: The current research aims to compare the effects of biofeedback flutter devices with the conventional flutter in managing the symptoms of patients with chronic obstructive pulmonary diseases. METHODS: One hundred and sixty-eight participants were randomly allocated into four groups: Group A (conventional), Group B (visual biofeedback), Group C (auditory biofeedback) and Group D (visual and auditory biofeedback). All groups were treated five days for 20 minutes. Outcome measures included wet sputum weight [during intervention (T1) and 1 hour after intervention (T2)], oxygen saturation and dyspnea score (before and after intervention) on all days. RESULTS: The wet sputum expectorated (T2) by Group B was significantly higher than Group A (P< 0.001), Group C (P< 0.001) and Group D (P< 0.05). The dyspnea score for Group B (P< 0.05), Group C (P< 0.05) and Group D (P< 0.05) was significantly lower than Group A. The post-intervention oxygen saturation level was higher in Group D followed by Groups B, C and A. CONCLUSION: The use of biofeedback flutter is effective in the removal of secretion, reducing dyspnea and improving oxygen saturation when compared to conventional flutter.

scholarly journals Anal sphincter dysfunction in multiple sclerosis: an observation manometric study

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 509-517 ◽  
Author(s):  
Silvia Marola ◽  
Alessia Ferrarese ◽  
Enrico Gibin ◽  
Marco Capobianco ◽  
Antonio Bertolotto ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Fecal Incontinence ◽  
Anal Pressure ◽  
Before And After ◽  
Group A ◽  
The Difference ◽  
Resting Anal Pressure ◽  
Group B ◽  
Multiple Sclerosis Patients ◽  
Group D

AbstractConstipation, obstructed defecation, and fecal incontinence are frequent complaints in multiple sclerosis. The literature on the pathophysiological mechanisms underlying these disorders is scant. Using anorectal manometry, we compared the anorectal function in patients with and without multiple sclerosis.136 patients referred from our Center for Multiple Sclerosis to the Coloproctology Outpatient Clinic, between January 2005 and December 2011, were enrolled. The patients were divided into four groups: multiple sclerosis patients with constipation (group A); multiple sclerosis patients with fecal incontinence (group B); non-multiple sclerosis patients with constipation (group C); non-multiple sclerosis patients with fecal incontinence (group D). Anorectal manometry was performed to measure: resting anal pressure; maximum squeeze pressure; rectoanal inhibitory reflex; filling pressure and urge pressure. The difference between resting anal pressure before and after maximum squeeze maneuvers was defined as the change in resting anal pressure calculated for each patient.ResultsGroup A patients were noted to have greater sphincter hypotonia at rest and during contraction compared with those in group C (p=0.02); the rectal sensitivity threshold was lower in group B than in group D patients (p=0.02). No voluntary postcontraction sphincter relaxation was observed in either group A or group B patients (p=0.891 and p=0.939, respectively).ConclusionsThe decrease in the difference in resting anal pressure before and after maximum squeeze maneuvers suggests post-contraction sphincter spasticity, indicating impaired pelvic floor coordination in multiple sclerosis patients. A knowledge of manometric alterations in such patients may be clinically relevant in the selection of patients for appropriate treatments and for planning targeted rehabilitation therapy.

scholarly journals The nature of COPD revealed by self-tracking, PRO-data and analysis of contact pattern for participants in a personalized health centered living lab organized according to the Epital Care Model. A longitudinal study. (Preprint)

2020 ◽  
Author(s):  
Klaus Phanareth ◽  
Astrid Laura Dam ◽  
Martin ABC Hansen ◽  
Signe Lindskrog ◽  
Søren Vingtoft ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pulmonary Function ◽  
Oxygen Saturation ◽  
Healthcare Professionals ◽  
Factor Group ◽  
Chronic Obstructive ◽  
Care Model ◽  
Copd Patients ◽  
Group A ◽  
Group D

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death and is characterized by a progressive loss of pulmonary function over time with intermittent episodes of exacerbations. Rapid and proactive interventions may reduce the burden of the condition for the patients. Telehealth solutions involving self-tracking of vital parameters such as pulmonary function, oxygen saturation, heart rate and temperature with synchronous communication of health data may become a powerful solution as they enable healthcare professionals to react with a pro-active and adequate response. We have taken this idea to the next level in the Epital Care Model (ECM) and organized a person-centered technology assisted ecosystem to provide health services to COPD patients. OBJECTIVE The objective is to reveal the nature of COPD by combining technology with a person-centered design aimed to benefit from interactions based on PRO data and to assess the needed kind of contacts to best treat exacerbations. We wanted to know: 1) What is the incidence of mild, moderate and severe exacerbations in a mixed population of COPD patients? 2) What is the course of the mild, moderate and severe exacerbations? And 3) How is the activity and pattern of contacts to health professionals related to the participants condition? METHODS Convenience sampling during the period November 2013 to December 2015. The participants’ sex, age, FEV1, pulse rate and oxygen saturation were registered at entry. During the study, we registered number of days, number of exacerbations, number of contact notes coded into care and treatment notes. Each participant was classified according to GOLD I-IV and risk factor group A-D. Participants reported their clinical status using a tablet by answering four questions and sending three semi-automated measurements. RESULTS Of the 87 participants, 11 were in risk factor group A, 24 in B, 13 in C and 39 in D. The number of observed days was 31801 days with 12470 measurements and 1397 care notes and 1704 treatment notes. A total of 254 exacerbations were treated and only 18 caused hospitalization. Those in risk factor group D have the highest number of hospitalizations (16), exacerbations (151), and contacts (1910) The initial contacts during the first month declined within three months to 1/3 for care contacts and 1/2 for treatment contacts and reached a plateau after four months. CONCLUSIONS The majority of COPD patients in risk factor group D can be managed virtually and only 13% of those with severe exacerbations required hospitalization. Contact to the healthcare professionals decreases markedly within the first months after enrollment. These results provide a new and detailed insight into the course of COPD. We propose a resilience index for virtual clinical management making it easier to compare results across settings.

scholarly journals Rabeprazole Combined with Hydrotalcite is Effective for Patients with Bile Reflux Gastritis after Cholecystectomy

2010 ◽  
Vol 24 (3) ◽  
pp. 197-201 ◽  
Author(s):  
Huimin Chen ◽  
Xiaobo Li ◽  
Zhizheng Ge ◽  
Yunjie Gao ◽  
Xiaoyu Chen ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Bile Reflux ◽  
Histological Finding ◽  
Reflux Gastritis ◽  
Before And After ◽  
Effective Therapeutic Option ◽  
Group A ◽  
Histological Activity ◽  
Group B ◽  
Group D

BACKGROUND: Regardless of surgical technique, patients who have undergone cholecystectomy appear to be predisposed to the development of bile reflux gastritis.OBJECTIVE: To assess the efficacy of rabeprazole and hydrotalcite in patients with bile reflux gastritis after cholecystectomy.METHODS: Postcholecystectomy patients with bile reflux gastritis confirmed by endoscopy and 24 h gastric bilirubin monitoring were randomly assigned to one of four eight-week treatments: observation (group A), rabeprazole alone (group B), hydrotalcite alone (group C) and rabeprazole in combination with hydrotalcite (group D). Endoscopy and 24 h gastric bilirubin monitoring were repeated in all patients after treatment. Dyspeptic symptoms of abdominal pain, bloating, heartburn, bitter taste, endoscopic and histological finding, and biliary reflux were evaluated before and after treatment.RESULTS: After administering medication, patient symptoms in groups B, C and D were relieved – most significantly in group D (P<0.05). There were no significant differences in endoscopic hyperemia and histological inflammation among the groups (P>0.05). However, histological activity, the number of reflux episodes and the number of reflux episodes lasting longer than 5 min were significantly decreased only in group D (P<0.05). The total per cent of bilirubin absorption (value of 0.14 units or greater) time was decreased in groups B, C and D, and most significantly in group D (P<0.05).CONCLUSION: Rabeprazole combined with hydrotalcite is an effective therapeutic option in the treatment of patients with bile reflux gastritis after cholecystectomy.

scholarly journals The Effect of Oral Administration of Pistacia Atlantica Kurdica Gum on the Eradication of Helicobacter Pylori in Patients with Dyspepsia: A Randomized Clinical Trial

2016 ◽  
Vol 9 (2) ◽  
pp. 256 ◽  
Author(s):  
Hamidollah Afrasiabian ◽  
Mohammad Hadi Imanieh ◽  
Mohammad Ali Nejati ◽  
Alireza Salehi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Demographic Situation ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
H Pylori ◽  
Group B ◽  
Group D ◽  
Common Infections

<p><em>H. pylori</em><strong> </strong>infection is one of the most common infections in the world so that the aim of this study was to evaluate the antimicrobial <em>P. Atlantica Kurdica</em> gum in the eradication of <em>H. pylori</em>. This study is a randomized clinical trial; Patients with positive Urea Breath Test and symptoms of dyspepsia were entered. Patients were randomly divided into four groups. Group A: three drugs including 500 mg of Amoxicillin twice a day (bd), Clarithromycin 500 mg bd and Omeprazole 20 mg (bd) and Group B: Group A drugs plus the capsule containing 1 g of powdered <em>P. Atlantica Kurdica </em>gum (bd). In Group C: the capsule containing 1 g of powdered <em>P. Atlantica Kurdica</em> gum (bd) and Group D: this group took placebo-containing capsule (bd) for 14 days respectively. Dyspeptic symptoms before and after healing period and the UBT results two days before the start of treatment and 30 days after the completion were compared in 4 groups. Patients were not statistically significant difference from each other in the four groups regarding the demographic situation. Moreover, <em>H. pylori</em> eradication rate was 19/24 in Group A, 18/24 in Group B, 10/23 in Group C and 2/24 in Group D. Relieving symptoms of dyspepsia in Groups B and C were significantly higher than in Group D (P=0.025 and p=0.006 respectively). <em>P. Atlantica Kurdica</em> significantly led to the treatment of dyspepsia symptoms and <em>H. pylori</em> eradication.</p>

scholarly journals A multivariate comparative clinical pharmacotherapeutic efficacy and chronopharmacovigilance assessment study of ofloxacin, one of the commonplace, TGFβ1 inducing and telomerase impairing fluoroquinolones, in treating acute gastroenteritis, chronic obstructive pulmonary disease, new drug-sensitive tuberculosis, recurrent mixed cutaneous infections, and post-surgical refractory wound infections, among the global patients, with heterogenous pharmacogeographic and pharmacogenomic constitution

2021 ◽  
Vol 10 (3) ◽  
pp. 270
Author(s):  
Moumita Hazra
Keyword(s):  
Recovery Time ◽  
Chronic Obstructive ◽  
Wound Infections ◽  
Obstructive Pulmonary Disease ◽  
Cutaneous Infections ◽  
Assessment Study ◽  
Group A ◽  
Time Periods ◽  
Group B ◽  
Group D

Background: Ofloxacin has an inhibitory effect on DNA gyrase, DNA topoisomerase IV and IL-1α, IL-6, IL-8, TNFa; and a superinducing effect on IL-2. Ofloxacin has profound bactericidal, anti-tubercular, anti-leprotic, anti-viral including anti-coronavirus, anti-fungal, anti-protozoal, comedolytic, anti-comedogenic, anti-inflammatory, immunomodulatory, and anti-malignant: pro-apoptotic and anti-proliferative potential, including TGFb1 targeted G2 phase cell cycle arrest and telomerase activity impairment. Objectives of the study were a comparative clinical pharmacotherapeutic efficacy and chronopharmacovigilance assessment study, of ofloxacin, one of the commonplace TGFb1 inducing and telomerase impairing fluoroquinolones, in treating heterogenous global patients, suffering from different diseases.Methods: A prospective, multivariate study of 100 patients, allotted into group A (acute gastroenteritis) =20, group B (chronic obstructive pulmonary disease) =20, group C (new drug-sensitive tuberculosis) =20, group D (recurrent mixed cutaneous infections) =20, and group E (post-surgical refractory wound infections) =20, was prescribed ofloxacin 200-400 mg twice daily, according to required prescribed regimens. A comparative pharmacotherapeutic efficacy assessment was made from the complete recovery time-periods, including the residual recovery time-periods. The chronopharmacovigilance assessment was made by adverse effects occurrence monitoring during treatment period or follow-up, with an Adverse Event Case Report Form. Results: The residual recovery time-periods, in group A=0 days, group B=2 days, group E=3 days, group D=3 days, and group C=7 days. Adverse effects were not statistically significant, with a predictable chronopharmacovigilance illustration.Conclusions: The pharmacotherapeutic efficacy of ofloxacin was more for treating group A, followed by group B, followed by group E and group D, and finally followed by group C. Ofloxacin was safe, without any pharmacogenomic or pharmacogeographic heterogeneity related fluctuation.

scholarly journals Comparison of Diaphragmatic Stretch Technique and Manual Diaphragm Release Technique on Diaphragmatic Excursion in Chronic Obstructive Pulmonary Disease: A Randomized Crossover Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Aishwarya Nair ◽  
Gopala Krishna Alaparthi ◽  
Shyam Krishnan ◽  
Santhosh Rai ◽  
R. Anand ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Release Technique ◽  
Before And After ◽  
Midaxillary Line ◽  
Group A ◽  
Midclavicular Line ◽  
Group B ◽  
The Right

Background. Chronic Obstructive Pulmonary Disease (COPD) impairs the function of the diaphragm by placing it at a mechanical disadvantage, shortening its operating length and changing the mechanical linkage between its various parts. This makes the diaphragm’s contraction less effective in raising and expanding the lower rib cage, thereby increasing the work of breathing and reducing the functional capacity. Aim of the Study. To compare the effects of diaphragmatic stretch and manual diaphragm release technique on diaphragmatic excursion in patients with COPD. Materials and Methods. This randomised crossover trial included 20 clinically stable patients with mild and moderate COPD classified according to the GOLD criteria. The patients were allocated to group A or group B by block randomization done by primary investigator. The information about the technique was concealed in a sealed opaque envelope and revealed to the patients only after allocation of groups. After taking the demographic data and baseline values of the outcome measures (diaphragm mobility by ultrasonography performed by an experienced radiologist and chest expansion by inch tape performed by the therapist), group A subjects underwent the diaphragmatic stretch technique and the group B subjects underwent the manual diaphragm release technique. Both the interventions were performed in 2 sets of 10 deep breaths with 1-minute interval between the sets. The two outcome variables were recorded immediately after the intervention. A wash-out period of 3 hours was maintained to neutralize the effect of given intervention. Later the patients of group A and group B were crossed over to the other group. Results. In the diaphragmatic stretch technique, there was a statistically significant improvement in the diaphragmatic excursion before and after the treatment. On the right side, p=0.00 and p=0.003 in the midclavicular line and midaxillary line. On the left side, p=0.004 and p=0.312 in the midclavicular and midaxillary line. In manual diaphragm release technique, there was a statistically significant improvement before and after the treatment. On the right side, p=0.000 and p=0.000 in the midclavicular line and midaxillary line. On the left side, p=0.002 and p=0.000 in the midclavicular line and midaxillary line. There was no statistically significant difference in diaphragmatic excursion in the comparison of the postintervention values of both techniques. Conclusion. The diaphragmatic stretch technique and manual diaphragm release technique can be safely recommended for patients with clinically stable COPD to improve diaphragmatic excursion.

Changes of respiratory input impedance during breathing in humans

1992 ◽  
Vol 73 (6) ◽  
pp. 2355-2362 ◽  
Author(s):  
M. Cauberghs ◽  
K. P. Van de Woestijne
Keyword(s):  
Chronic Obstructive Lung Disease ◽  
Upper Airway ◽  
Chronic Obstructive ◽  
Respiratory Resistance ◽  
Disease Group ◽  
Obstruction Group ◽  
Group A ◽  
The Subject ◽  
Group B ◽  
Group D

Changes of total respiratory resistance (Rrs) and reactance (Xrs) were studied between 8 and 32 Hz at five moments during the respiratory cycle in healthy adults (group A) and children (group B) and in patients with chronic obstructive lung disease (group C) and with upper airway obstruction (group D). Two forced oscillation techniques were used: the conventional one and the head generator, with the oscillations applied at the mouth and around the head of the subject, respectively. Both techniques yielded similar results. Rrs is lowest during the transition from inspiration to expiration and highest in the course of expiration, except in group D. Mean Xrs is highest at the transitions from inspiration to expiration or vice versa and lowest during expiration, except in group D. In groups C and D, the increases of Rrs are accompanied by a more pronounced negative frequency dependence of Rrs. The variations of Rrs and Xrs appear to be markedly flow dependent and may be a consequence of the interaction of breathing with oscillatory flows.

Study the Relationship Between Estrogen Hormone and Calcium in Normal Females Before and After Menopause in Baghdad / Iraq

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Sameerah Mustafa ◽  
Asal Tawfeeq ◽  
Hadeel Hasan
Keyword(s):  
Oral Contraceptive ◽  
Healthy Controls ◽  
Serum Samples ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Menopausal Women ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Age Range

This study involved the collection of (90) samples of women serum which included (30) serum samples collected from women before menopause (reproductive women) in the age range of (22-43) years and were considered as (group A- control). While, (group B) included (30) serum samples collected from women using oral contraceptive pills between the ages of (22-43) years old. Whereas, another (30) serum samples were collected from women after menopause between the ages of (43-54) years and were considered as (group C). All of the collected serum samples were subjected to a number of serological and chemical tests for the measurement of (E2, HDL, LDL and Ca). Then, the obtained data were statistical analyzed and results showed a significant decrease (p˂ 0.05) in (E2 ,Ca and HDL) levels in menopausal women compared to that of the normal healthy controls. While, there were non-significant decrease (p> 0.05) in (E2, Ca and HDL) levels in women taking oral contraceptive when compared to the normal healthy controls. On the other hand, a significant increase (p˂ 0.05) was recorded in LDL level in menopausal women compared to that of the normal healthy controls whereas, no-significant increase (p˃ 0.05) in the LDL level in women taking oral contraceptives when compared to the control women.

A Comparative Study of Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana in the Management of Shweta Pradara

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Renuka M. Tenahalli
Keyword(s):  
Vitamin C ◽  
Early Stage ◽  
Pathological Condition ◽  
Before And After ◽  
Group A ◽  
Phosphorus Iron ◽  
Group B ◽  
Busy Schedule ◽  
Iron And Calcium

Shweta Pradara (Leucorrhoea) is the disease which is characterized by vaginal white discharge. Vaginal white discharge this symptom is present in both physiological and pathological condition, when it becomes pathological it disturbs routine life style of the woman. Most of the women in the early stage will not express the symptoms because of hesitation and their busy schedule. If it is not treated it may leads to chronic diseases like PID (Garbhashaya Shotha etc.) Charaka mentioned Amalaki Choorna along with Madhu and Vata Twak Kashaya Yoni Pichu Dharana. This treatment is used in Shweta Pradara shown positive results, hence a study was under taken to assess its clinical efficacy. 30 diagnosed patients of Shweta Pradara were randomly selected, allocated in three groups. Group A and Group B received Amalaki Choorna with Madhu and Vata Twak Kashaya Yoni Pichu Dharana respectively and Group C received Amalaki Choorna with Madhu followed by Vata Twak Kashaya Yoni Pichu Dharana for 15 days. The patients were assessed for the severity of the symptoms subjectively and objectively before and after the treatment and at the end of the follow up. Data from each group were statistically analyzed and were compared. No side effects were noted and it may be considered as an effective alternative medicine in Shweta Pradara (leucorrhea). Amalaki is rich in natural source of vitamin C and contains phosphorus, iron and calcium. Honey contains carbohydrate, vitamin C, phosphorus iron and calcium. All together these help to increase Hb% and immunity. Vata Twak Kashaya contains tannin which helps to maintain normal pH of the vagina.

Survival of classic swine fever virus in hams made from the meat of pigs vaccinated with the PAV-250 strain and unvaccinated pigs

2019 ◽  
Vol 10 (3) ◽  
pp. 536-551
Author(s):  
Heidi Amezcua Hempel ◽  
María Salud Rubio Lozano ◽  
Eliseo Manuel Hernández Baumgarten ◽  
Pablo Correa Girón † ◽  
Oscar Torres Ángeles ◽  
...  
Keyword(s):  
Reference Strain ◽  
Clinical Signs ◽  
Classical Swine Fever ◽  
Fever Virus ◽  
Direct Immunofluorescence ◽  
Biometric Analysis ◽  
Treatment Groups ◽  
Group A ◽  
Group B ◽  
Group D

The study was to determine the presence of Classical Swine Fever virus (CSFv), in the meat of vaccinated pigs with the PAV-250 strain and then challenged using the same strain. Five treatment groups were established (each with four pigs). Group A: Pigs thatwere fed with processed hams from negative animals; Group B: Pigs that were fed with processed hams from commercial pigs inoculated with the ALD (reference strain) (titre of 104.0/ml); Group C: Pigs fed with processed hams from pigs infected with the virulent ALD strain (titre of 102.5/ml); Group D: Pigs fed with processed hams from pigs vaccinated with the PAV-250 strain and challenged with the ALD strain (titre of 101.1/ml); and Group E: Pigs fed with processed hams from pigs vaccinated with two doses of the PAV-250 strain and challenged with the ALD strain (negative). Blood samples were taken at d 1, 5, 10, 15 and 20 for biometric analysis. Groups B, C and D manifested clinical signs of CSFv: 40 °C temperature, anorexia, paralysis, vomiting, diarrhea, tremor, hirsute hair and cyanosis. Pigs were slaughtered and necropsies performed to identify lesions in tissues. Results of direct immunofluorescence testing of tissues were positive and the virus was recovered. Under these study conditions, it was found that CSFv resisted the cooking method at 68 °C for 40 min in hams from unvaccinated pigs, and that the virus was able to transmit the disease to healthy unvaccinated pigs, whereas the hams from the vaccinated animals did not transmit the virus.

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