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Efficacy of Phloroglucinol Tamsulosin Combination Therapy for Medical Expulsion of Lower Ureteral Calculi and Influence on Patients’ Cys-C Level 间苯三酚-坦索罗辛联合治疗输尿管下段结石药物排出的疗效及对患者Cys-C水平的影响
Advanced Biomedicine Pub Date : 2021-04-16 DOI: 10.11648/J.AJCEM.20210901.14
Yutong Li, B. Pan, Guo Chen, Ying Wu
{"title":"Efficacy of Phloroglucinol Tamsulosin Combination Therapy for Medical Expulsion of Lower Ureteral Calculi and Influence on Patients’ Cys-C Level","authors":"Yutong Li, B. Pan, Guo Chen, Ying Wu","doi":"10.11648/J.AJCEM.20210901.14","DOIUrl":"https://doi.org/10.11648/J.AJCEM.20210901.14","url":null,"abstract":"Objective: Phloroglucinol is a myotropic, non-atropine and non-papaverine smooth muscle antispasmodic which directly acts on the smooth muscles of the gastrointestinal tract and the urogenital tract with no anticholinergic effect, no symptoms like xerostomia, visual impairment, dysuria, hypotension, increased heart rate, and arrhythmia etc. To investigate the efficacy of phloroglucinol tamsulosin combination therapy for medical expulsion of lower ureteral calculi and influence on patients’ Cys-C level. Methods: Equally randomized 136 patients with lower ureteral calculi in our hospital into mono therapy group (phloroglucinol alone) and combination therapy group (additional tamsulosin was advised). The expulsion rate, expulsion time, stone diameter and levels of IL-10, CRP, NGAL, Cys-C, KIM-1 were compared between two groups, also with the effectiveness and the rate of adverse reactions. Results: The combination therapy group showed higher expulsion rate (P<0.05) and shorter expulsion time (P<0.05) than that of the mono therapy group and the stone diameter was slightly larger as well (P<0.05). Also, patients under combination treatment had elevated IL-10, CRP, NGAL, Cys-C and KIM-1 levels and a better overall response rate (P<0.05) while it was associated with a slightly higher rate of adverse reactions (P>0.05). Conclusions: Phloroglucinol tamsulosin combination therapy had clear advantages on medical expulsion of lower ureteral calculi in respect of higher expulsion rate and elevated IL-10, CRP, NGAL, Cys-C and KIM-1 levels with larger stone diameter in a shorter time.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88161951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Infection Control Impact on Patient with Tuberculosis Chroretinitis in KSA Hospital Based Analysis KSA医院结核性视网膜炎患者感染控制效果分析
Advanced Biomedicine Pub Date : 2021-02-25 DOI: 10.54730/abm.2021.030104
Mohammed Ahmed Garout, Emad Emad Algahdaly, Magda Ramadan Abdultawab, Rana Mohammed Garout, Raha Mohammed Garout
{"title":"Infection Control Impact on Patient with Tuberculosis Chroretinitis in KSA Hospital Based Analysis","authors":"Mohammed Ahmed Garout, Emad Emad Algahdaly, Magda Ramadan Abdultawab, Rana Mohammed Garout, Raha Mohammed Garout","doi":"10.54730/abm.2021.030104","DOIUrl":"https://doi.org/10.54730/abm.2021.030104","url":null,"abstract":"Tuberculosis (TB) is an infectious disease responsible for significant morbidity and mortality worldwide. WHO estimates that one third of the world’s population is currently infected, with 9 million new cases occurring annually, leading to 3 million deaths per year, the disease affects the ocular anterior segment, the posterior segment, and adnexa. , The intraocular manifestations of TB include “mutton fat” keratic precipitates, posterior synechiae, vitreous snowballs, snow banking, retinal vasculitis, choroiditis, serpiginous-like choroiditis, and panuveitis] A definitive diagnosis of intraocular TB requires culture data, and direct demonstration of Mycobacterium tuberculosis in smears and via polymerase chain reaction (PCR) of intraocular fluid, The purpose of this study is to describe the ocular manifestations, diagnosis and treatment of tuberculosis and to emphasize the fact that ocular tuberculosis may occur in the absence of systemic clinical activity and may mimic several clinical entities The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a hospital. Study the prevalence of ocular TB in cross section eye care center Magrabi hospital Jeddah, KSA, from June 1, 2013 to December 31, 2015. diagnosis of ocular TB is often presumed in the presence of suggestive ocular findings in combination with any of the following: Systemic findings consistent with TB infection, Positive interferon gamma release assay, Positive tuberculin skin test in asymptomatic individuals, Acid-fast bacilli (AFB) on direct smear or culture of MTB from ocular samples, Polymerase chain reaction (PCR), Fluorescein angiography (FA), RESULTS: 86 of 2542 patients for examination of retina in retina clinic were diagnosed as suspected tuberculosis chroretinitis, 20 percent of them had conformed diagnosed as TB. out Of 86, 24 (27.9%) had at least one episode of oculacomplaints, 7 patients were conformed with PCR. CONCLUSION: The diagnosis of presumed ocular tuberculosis remains a clinical challenge, although interferon-γ release assays they currently lack the specificity to distinguish between latent tuberculosis infection and active tuberculosis. molecular diagnostic PCR may be valuable in our ability to establish an earlier etiologic diagnosis and institute appropriate antimycobacterial therapy and ensure from implementation of infection control measurements.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73596487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Philosophicum-Model Project of Philosophy of Medicine in Medical Education and Practice in Germany Perspective Article 德国医学教育与实践中的哲学-医学哲学模式项目透视文章
Advanced Biomedicine Pub Date : 2021-02-25 DOI: 10.54730/abm.2021.030101
Jonas Daub, Hans Christoph Aster, Hannah Gauger, Till Gallasch, Michael Schmidt, Johann Heinrich Koenigshausen, T. Bohrer
{"title":"The Philosophicum-Model Project of Philosophy of Medicine in Medical Education and Practice in Germany Perspective Article","authors":"Jonas Daub, Hans Christoph Aster, Hannah Gauger, Till Gallasch, Michael Schmidt, Johann Heinrich Koenigshausen, T. Bohrer","doi":"10.54730/abm.2021.030101","DOIUrl":"https://doi.org/10.54730/abm.2021.030101","url":null,"abstract":"Medical and philosophical thinking belong together, cannot be separated neither in scientific theory nor in practice, and only the symbiosis of both can face the challange to reflect the basic phenomenon of both of these desiciplines: human life itself. No patient expects to be treated exclusively on the basis of the latest scientific results, but also wants to be perceived by his doctor as an unique individual. It is the doctor’s specific task to embed the scientifically developed diagnoses therapeutically into each individual patient’s biography. Furthermore such a perspecitve increases patient safety and it enables a future of trust in the doctor-patient relationship. The „Philosophicum“ is a model project in Germany that brings together philosophers, physicians and students to do research and education in the broad and enriching intersection of medicine and philosophy. Based on many years of experience, we are convinced that a structured philosophical education can substantially improve medical studies and subsequently doctors‘ work. Medical anthropology and hermeneutics are necessary and also teachable. The preparation should start early in the medical education and should be strengthened by bedside training while interacting with the patient. This requires philosophically interested and trained doctors and students. Exactely for that reason we favor integrating a philosophicum into the medical eduacation and practice.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76105171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Central Diabetes Insipidus in a Patient with Stiff Person Syndrome 中枢性尿崩症伴僵硬人综合征1例
Advanced Biomedicine Pub Date : 2020-08-26 DOI: 10.54730/abm.2020.020404
Fatima Zarzour, Abir Bou Khalil, B. Khalil
{"title":"Central Diabetes Insipidus in a Patient with Stiff Person Syndrome","authors":"Fatima Zarzour, Abir Bou Khalil, B. Khalil","doi":"10.54730/abm.2020.020404","DOIUrl":"https://doi.org/10.54730/abm.2020.020404","url":null,"abstract":"Background: Central diabetes insipidus (CDI) is a rare hypothalamic-pituitary disease due to the deficiency of arginine vasopressin (AVP) synthesis of which more than one third of etiologies are unidentified. Autoimmunity is associated with one third of patients with apparently idiopathic CDI. The most common antibody detected in auto immune CDI is autoantibodies to AVP-secreting cells (AVPcAb). Stiff-person syndrome (SPS) is a rare neurological disorder with features of an autoimmune disease. It is characterized by fluctuating muscle rigidity in the trunk and limbs and a heightened sensitivity to stimuli. It is well known that SPS is associated with multiple auto immune endocrinopathy including auto immune diabetes and auto immune thyroid disease. The association between SPS and CDI is not well documented in the literature. Case information: We report a case of 51 year old female who developed CDI while being treated for SPS unmasked by high dose steroids. Result: Anti amphiphysin is the only antibody detected in our patient. Animal studies showed a high expression of amphiphysin in anterior and posterior pituitary gland, data in human are still vague .One theory is that anti-amphiphysin antibodies attack the amphiphysin molecules in the AVP secreting cells and inhibit release of AVP. Conclusion: This antibody could hint towards the autoimmune cause of CDI.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74694768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Degree of Control and Main Complications of Hyperthyroid Pregnant Women in a Real Life Experience with Methimazol 甲巯咪唑对甲亢孕妇控制程度及主要并发症的影响
Advanced Biomedicine Pub Date : 2020-06-26 DOI: 10.54730/abm.2020.020305
Díaz Arizmendi Diana Elizabeth, Mendieta Zerón Hugo
{"title":"Degree of Control and Main Complications of Hyperthyroid Pregnant Women in a Real Life Experience with Methimazol","authors":"Díaz Arizmendi Diana Elizabeth, Mendieta Zerón Hugo","doi":"10.54730/abm.2020.020305","DOIUrl":"https://doi.org/10.54730/abm.2020.020305","url":null,"abstract":"Hyperthyroidism is one of the main endocrinopathies during pregnancy. The aim of this project was to identify the degree of control of hyperthyroid pregnant women based on the recommendations of the American Thyroid Association (ATA) in a real situation without the availability of propylthiouracil. This was a descriptive, retrospective and longitudinal study, including medical files of pregnant women with hyperthyroidism between 18 and 35 years. They were classified as having \"Adequate\" control if their thyroid profiles were within the recommendations of the ATA and had no adrenergic symptoms; and were categorized as having \"Inadequate\" control if they were not stabilized with monotherapy, or if they required high doses of antithyroid drugs or beta-blockers or showed serious complications including the need of an Intensive Care Unit (ICU) for mothers or neonates. The Chi square test was performed between treatment groups during the third trimester and the complications of pregnant women or neonates. A total of 173 hyperthyroid pregnant women were studied with an average age of 21 ± 4.7 years. Of the 33 patients with hyperthyroidism who received monotherapy with methimazole until the end of pregnancy, 23 (69.69%) were classified as having \"Adequate\" control. In a real life situation there is delay in the diagnosis of hyperthyroidism during pregnancy but even without propylthiuracil, an “Adequate” control can be reached in up to 20.53% of cases based on a methimazole monotherapy.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74115167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Relationship Between Resting Heart Rate and Age in Adult Nigerians 尼日利亚成年人静息心率与年龄的关系
Advanced Biomedicine Pub Date : 2019-12-26 DOI: 10.54730/abm.2019.010504
Oko-Jaja Richard I., Shamsuddin Chowdhry Pracha, Omair A. Mohiuddin
{"title":"The Relationship Between Resting Heart Rate and Age in Adult Nigerians","authors":"Oko-Jaja Richard I., Shamsuddin Chowdhry Pracha, Omair A. Mohiuddin","doi":"10.54730/abm.2019.010504","DOIUrl":"https://doi.org/10.54730/abm.2019.010504","url":null,"abstract":"Background: Resting heart rate is related to cardiovascular mortality as well as to all-cause mortality. It is therefore important to know whether resting heart rate changes with age in adults. The aim of this study was to determine the relationship between heart rate and age in adult Nigerians. Methods: It was a retrospective study on adult Nigerians attending a University Teaching Hospital in Nigeria. All the needed data were retrieved from the medical records. Heart rate was calculated from the electrocardiogram and correlated with age. Results: There were 99 cases aged between 20 and 54 years and comprised of 60 males and 39 females. The mean heart rate was 73.40±13.16 beats/minute. Across the various decades, the mean heart rate in beats per minute was 73.46±10.70 in the third decade, 75.52±12.16 in the fourth decade, 72.38±13.91 in the fifth decade, and 71.60±18.77 in the sixth decade of life (p=0.770). Heart rate correlated negatively and weakly with age (r=- 0.034, p=0.736). There were more cases of sinus bradycardia than sinus tachycardia, but the proportion of cases with heart rate outside 60 beats per minute to 100 beats per minute was small. Conclusion: This study showed that resting heart rate did not change with age in young adult and middle-aged Nigerians who had no clinical evidence of heart disease. A greater proportion of them were in normal sinus rhythm.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77330137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Contribution of Scanner in the Breast Cancer Extension Assessment in the Radiology Department of CNHU-HKM in Benin 扫描仪在贝宁CNHU-HKM放射科乳腺癌扩展评估中的贡献
Advanced Biomedicine Pub Date : 2019-10-26 DOI: 10.54730/abm.2019.010403
Yekpe Ahouansou Patricia, Adjadohoun Sonia, Lokossou Symphorose, Ngamo Gabriel, Lokossou Andreas, Kiki Miralda, Akanni Djivèdé, Biaou Olivier
{"title":"Contribution of Scanner in the Breast Cancer Extension Assessment in the Radiology Department of CNHU-HKM in Benin","authors":"Yekpe Ahouansou Patricia, Adjadohoun Sonia, Lokossou Symphorose, Ngamo Gabriel, Lokossou Andreas, Kiki Miralda, Akanni Djivèdé, Biaou Olivier","doi":"10.54730/abm.2019.010403","DOIUrl":"https://doi.org/10.54730/abm.2019.010403","url":null,"abstract":"Objective: Breast cancer is the most common female cancer in the world. The prognosis depends on whether metastasis is present or not. The objective of this study was to provide an overview of the CT scan aspects identified during the evaluation of breast cancer extension in the Radiology department of the Teaching University Hospital of Hubert Koutoukou Maga (CNHU-HKM) in Cotonou in Benin. Materials and methods: It was a descriptive study with retrospective collection, conducted from January 1, 2018 to January 31, 2019 (13 months), in the Radiology department of CNHU-HKM. It focused on patients referred for a chest-abdominal-pelvic computed tomography (PET) scan, as part of an extension assessment for breast cancer. Results: During the period of the study, 40 chest-abdominal-pelvic CT scans were compiled, of which 38 (95%) were women and 02 men (5%), and among which 23 were metastatic, accountings for a prevalence of 57.5%. The average age was 51.22±16.33 with extremes of 30 and 83 years old. Among our patients, 32 (80%) had undergone a CT scan for an initial diagnostic of extension assessment, and 08 (20%) for the therapeutic response assessment. According to the TNM classification, T4 tumors accounted for 27.5% (11 cases). Lymph node involvement was found in 18 cases (43.90%), accounting for 12 (30%) of N1 and 6 (15%) of N3. The most commonly found metastatic sites were the lung in 25% followed by the pleura and the liver with equal percentages (10%). The metastases CT scan aspect was typically a carcinomatous lymphangitis appearance; fluid pleural effusions; hypodenses, hypovascular nodules hepatics; osteolytic or mixed bone damage and peritoneum, especially fluid effusion associated with peritoneal nodules. Conclusion: The frequency of breast cancer metastases is high in Benin. The most commonly found metastatic sites on scanner in descending order are the lungs, liver and bones.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81196775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh 孟加拉国炎症性肠病患者诊断延迟的危险因素和影响
Advanced Biomedicine Pub Date : 2019-10-26 DOI: 10.54730/abm.2019.010404
Chanchal Kumar Ghosh, S. M. Ali Hasan, Md Abdur Rahim Miah
{"title":"Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh","authors":"Chanchal Kumar Ghosh, S. M. Ali Hasan, Md Abdur Rahim Miah","doi":"10.54730/abm.2019.010404","DOIUrl":"https://doi.org/10.54730/abm.2019.010404","url":null,"abstract":"Background and Aims: A delay in the diagnosis of inflammatory bowel disease (IBD) is a risk of developing complications and surgery. This study was done to evaluate the factors and impact of diagnostic delay on IBD patients in Bangladesh. Methods: This cross-sectional study was carried out in the Department of Gastroenterology of a tertiary care center in Bangladesh. Diagnostic delay was defined as the period from symptom onset to diagnosis of IBD. Results: Of the total 112 IBD patients 50 (44.6%) had Crohn’s disease CD and 62 (55.4%) had ulcerative colitis (UC). Males (67.9%) were predominant in the study. The median diagnostic delay was longer for patients with CD compared with patients with UC (median 24 versus 12 months; P-value 0.025). Rectal bleeding as presenting feature and male gender were negatively and positively associated with the longer diagnostic delay of IBD respectively (P-value <0.05). Of the patients with CD 14 (28%) had a history of IBD-related surgery and 7 (14%) had a history of perianal fistula. The presence of intestinal strictures, surgery, and perianal fistula at the time of diagnosis was significantly associated with long diagnostic delay for CD. Conclusion: Absence of rectal bleeding as presenting symptoms and also the male gender were the significant factors related to the longer diagnostic delay of IBD in our study. Long diagnostic delay is associated with an increased rate of complications in IBD, especially in CD.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84997335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Lag Time of Diagnosis of Axial Spondyloarthritis: A Bangladesh Perspective 诊断轴型脊椎关节炎的滞后时间:孟加拉国的观点
Advanced Biomedicine Pub Date : 2019-10-26 DOI: 10.54730/abm.2019.010405
Abu Tahir Muhammad Tanveer Has, M. Abdul Alim
{"title":"The Lag Time of Diagnosis of Axial Spondyloarthritis: A Bangladesh Perspective","authors":"Abu Tahir Muhammad Tanveer Has, M. Abdul Alim","doi":"10.54730/abm.2019.010405","DOIUrl":"https://doi.org/10.54730/abm.2019.010405","url":null,"abstract":"Background & Objective: The lag time of diagnosis of axial spondyloarthrits varies from country to country. The aim of this study was to find out the lag time of diagnosis of axial spondyloarthritis in Bangladesh based on the patients visiting the morning Rheumatology OPD of a tertiary-care hospital. Materials & Methods: This study was conducted in the Department of Rheumatology of Enam Medical College & Hospital, Savar, Dhaka, Bangladesh from October, 2018 to December, 2019. Ninety six patients with axial spondyloarthritis were recruited and they were enquired about their ages, places of residence, educational qualifications and duration of axial pain as well as peripheral pain. The participants also underwent estimation of ESR by Westergren method. Results: Mean age of the participants was 39.98 years. The mean and median lag times of diagnosis were 58.17 and 36 months respectively. The lag time of diagnosis followed a nonnormal (right-skewed) distribution. There was no significant difference between males and females (p≈0.921), between rural and urban participants (p≈0.221), between those with and without peripheral involvement (p≈0.387) as well as between those with and without elevated ESR according to Mann-Whitney U test. But the median lag time in those who were highly educated, ie. those who completed at least a bachelor degree was significantly (p≈0.016) shorter than that in those who were not highly educated. Conclusion: There is a considerable median delay in the diagnosis of axial spondyloarthritis in Bangladesh. Further research is required to identify the factors contributing to the delay so that those can be addressed to shorten the lag time.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87723000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Obstinate Refractory and Resistance Hypertension 顽固性、难治性高血压
Advanced Biomedicine Pub Date : 2019-06-26 DOI: 10.54730/abm.2019.010202
Raj Kamal Choudhry, Amrendra Kumar Singh
{"title":"The Obstinate Refractory and Resistance Hypertension","authors":"Raj Kamal Choudhry, Amrendra Kumar Singh","doi":"10.54730/abm.2019.010202","DOIUrl":"https://doi.org/10.54730/abm.2019.010202","url":null,"abstract":"Resistant hypertension (RHTN) is relatively common with an estimated prevalence of 10-20% of treated hypertensive patients. It is defined as blood pressure (BP) >140/90 mmHg treated with ≥3 antihypertensive medications, including a diuretic, if tolerated. Refractory hypertension is a novel phenotype of severe antihypertensive treatment failure. The proposed definition for refractory hypertension, i.e. BP >140/90 mmHg with use of ≥5 different antihypertensive medications, including a diuretic and a mineralocorticoid receptor antagonist (MRA) has been applied inconsistently. In comparison to RHTN, refractory hypertension seems to be less prevalent than RHTN. This review focuses on current knowledge about this novel phenotype compared with RHTN including definition, prevalence, mechanisms, characteristics and comorbidities, including cardiovascular risk. In patients with RHTN excess fluid retention is thought to be a common mechanism for the development of RHTN. Recently, evidence has emerged suggesting that refractory hypertension may be more of neurogenic etiology due to increased sympathetic activity as opposed to excess fluid retention. Treatment recommendations for RHTN are generally based on use and intensification of diuretic therapy, especially with the combination of a long-acting thiazide-like diuretic and an MRA. Based on findings from available studies, such an approach does not seem to be a successful strategy to control BP in patients with refractory hypertension and effective sympathetic inhibition in such patients, either with medications and/or device based approaches may be needed.","PeriodicalId":7179,"journal":{"name":"Advanced Biomedicine","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86519678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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