Acid In Management Research Articles

Role of Topical Ascorbic Acid in Management of Refractory Corneal Ulcer

Ascorbic acid, a water soluble vitamin, helps in collagen assembly, synthesis of neurotransmitters, has immune functions and also acts as a major antioxidant in the body. Refractory corneal ulcer is a challenging situation faced by every ophthalmologist in developing countries. Available treatment options for refractory corneal ulcer are bandage contact lens, grid keratotomy, therapeutic penetrating keratoplasty, amniotic membrane transplantation, nerve growth factors, aprotinin [proteases inhibitor]. These treatment options are costly and require expertise in preparation and use. Topical ascorbic acid has been known to have good results in caustic injury of cornea and in free radical damage after eximer laser surgery. This makes it a potential cost-effective candidate to be studied as an alternative in addition to conservative treatment for treating refractory corneal ulcer. This study aims to study the role of topical ascorbic acid in treatment of refractory corneal ulcers.

Comparative Effect of Interval and Continuous Training Programs on Serum Uric Acid in Management of Hypertension: A Randomized Controlled Trial

The purpose of the study was to investigate the effect of interval and continuous training program on blood pressure and serum uric acid (SUA) levels in subjects with hypertension. Three hundred and fifty-seven male patients with mild to moderate systolic blood pressure (SBP) between 140 and 179 and diastolic blood pressure (DBP) between 90 and 109 mm Hg essential hypertension were age-matched and grouped into interval, continuous, and control groups. The interval (work:rest ratio of 1:1) and continuous groups were involved in an 8-week interval and continuous training program of 45-60 minutes, at intensities of 60-79% of heart rate maximum, whereas the control group remained sedentary during this period. SBP, DBP, maximum oxygen uptake (VO2max) and SUA concentration were assessed. One-way analysis of variance and Scheffe and Pearson correlation tests were used in data analysis. Findings of the study revealed significant effect of exercise training program on VO2max, SBP, DBP, and SUA. However, there was no significant difference between the interval and continuous groups. Changes in VO2max negatively correlated with changes in SUA (r = -0.220) at p < 0.05. It was concluded that both moderate-intensity interval and continuous training programs are effective and neither seems superior to the other in the nonpharmacological management of hypertension and may prevent cardiovascular events through the downregulation of SUA in hypertension. Findings of the study support the recommendations of moderate-intensity interval and continuous training programs as adjuncts for nonpharmacological management of essential hypertension.

Hyaluronic acid in management of advanced osteoarthritis of the knee: retrospective analysis

Intra-articular hyaluronic acid injections is an accepted therapeutic alternative in the symptomatic management of knee osteoarthritis; however there are hardly any studies documenting possible benefit of hyaluronan in delaying the need for TKR. It was this intent our study was conducted. This was a retrospective chart analysis of 130 patients (75 females and 55 males) with varying degree of knee osteoarthritis treated over a 5-year period. The average age was 59.4 (range 15–92). Fifty-three patients had left knee involvement, right knee in 45 patients with 32 with bilateral involvement. Of the patients, 85% had advanced arthritis (grade ¾). All 130 patients had received hyaluronic acid injections. The total number of courses per knee was 1.604. In patients who had more than one course, the minimum interval between courses was 6 months with the longest interval being 36 months. Three patients (2.3%) developed toxic synovitis. Seventeen patients had a poor response at 6 months. Forty-five patients were advised surgery, but only 29 patients underwent surgery. All patients who underwent surgery had Grade 3/4 changes at the initial presentation. Of 109 patients, 65 (58.7%) patients with advanced arthritis did not undergo surgery and were doing well at final follow-up. Thus, hyaluronic acid injections can delay the need for total knee replacement.

Assessment of total sialic acid and lipid-bound sialic acid in management of brain tumors.

Background:Glycoconjugate molecules expressed at the plasma membrane of mammalian cells have been reported to be associated with tumor progression. The measurement of total sialic acid (TSA) and lipid-bound sialic acid (LBSA) in the cerebrospinal fluid (CSF) is suggested to be useful for the diagnosis of brain tumors. But there are very few reports available on the serum glycoconjugate levels in patients with brain tumors.Objective:The objective of this study is to check the feasibility of using serum glycoconjugates such as TSA and LBSA as tumor markers in brain tumor patients.Materials and Methods:Colorimetric estimation of TSA using diphenylamine was done on 100 patients with intracranial tumors; follow-up study was carried out in 24 cases. The LBSA fraction was isolated from the serum of 68 brain tumor patients and evaluated using phosphotungstic acid and resorcinol; follow-up study was done on 23 patients. The various types of brain tumors included in this study were glioma, meningioma, and acoustic neurinoma as well as some other types such as medulloblastoma, secondary tumors, and craniopharyngioma.Results:There was no significant difference between the TSA and LBSA concentrations seen in pretreatment or post-treatment cases and that seen in control subjects.Discussion:TSA and LBSA do not have the ability to discriminate between benign and malignant brain tumors. TSA and LBSA appear to be tumor markers of very limited value in patients with brain tumors.

Role of branched‐chain amino acids in management of cirrhosis and hepatocellular carcinoma

Altered protein and energy metabolism is a hallmark of chronic liver disease, characterized by decreased plasma branched-chain amino acids (BCAA) and increased plasma aromatic amino acids (AAA). Overwhelming evidence has indicated that the incidence of complications of chronic liver disease increases with malnutrition. Hence nutritional management in patients with chronic liver disease must receive high priority. The use of BCAA supplementation has been a controversial subject. This review summarizes published results of BCAA supplementation as a nutritional therapy for patients with cirrhosis and hepatocellular carcinoma (HCC). On balance, it would be appropriate to conclude that BCAA are associated with decreased frequency of complications of cirrhosis and improved nutritional status when prescribed as a maintenance therapy for patients with cirrhosis. More studies are, however, required to identify those who might benefit most from BCAA supplementation.

Role of tranexamic acid in management of dysfunctional uterine bleeding in comparison with medroxyprogesterone acetate

SummaryCurrently, tranexamic acid (TXA) is used as 4 g/day in menorrhagia This prospective randomised study included 100 cases to assess efficacy and safety of 2 g/day TXA in dysfunctional uterine bleeding (DUB) vs cyclical 10 mg twice-daily medroxyprogesterone acetate (MPA) for 3 cycles. Follow-ups were made monthly for 3 months during therapy, then 3 months after. Mean pictorial blood loss assessment chart (PBAC) score decreased from 356.9 to 141.6 in the TXA group and from the pre-treatment 370.9 to 156.6 with MPA and mean reduction of blood loss was 60.3% with TXA and 57.7% with MPA after 3 months (p < 0.005 in both groups). Lack of response during treatment was seen in three patients (6.1%) TXA and in 13 patients (28.9%) with MPA (p = 0.003). In patients who reported 3 months after stopping the treatment, 66.7% in TXA group and 50% in MPA had recurrence of menorrhagia, (p = 0.155). During the 6 months study period more hysterectomies were performed in the MPA than in the TXA group (17.8% vs 4%; p = 0.002). We conclude that TXA in 2 g/day dosage is an effective and safe option in DUB.

Costs and consequences of using pamidronate compared with zoledronic acid in the management of breast cancer patients in the UK

ABSTRACTObjective: To estimate the costs and consequences of using pamidronate compared to zoledronic acid in the prophylactic management of skeletal morbidity among breast cancer patients in the UK.Design and setting: This was a modelling study performed from the perspective of the UK's National Health Service (NHS).Methods: Published clinical outcomes from a comparative study were combined with resource utilisation estimates derived from a panel of clinicians. This enabled the construction of a decision model depicting the management of patients with breast cancer receiving antineoplastic therapy who are 18 years of age or above and who have at least one bone metastasis (lytic or mixed). There are no significant differences in outcome between using pamidronate and zoledronic acid in breast cancer patients. Therefore, a cost minimisation analysis was performed to identify the treatment strategy that achieves the same outcome for least cost. The expected time attributable to a pamidronate and zoledronic acid infusion was also estimated.Main outcome measures and results: Starting treatment with pamidronate among patients receiving chemotherapy is expected to lead to a healthcare cost of £6046 over 12 months compared to £6981 with zoledronic acid. In comparison, for patients receiving hormonal therapy, starting treatment with pamidronate is expected to lead to a healthcare cost of £5401 over 12 months compared to £6043 with zoledronic acid. This cost difference is primarily due to the lower acquisition cost of pamidronate and fewer tests among pamidronate-treated patients. Accordingly, pamidronate affords a less expensive management modality. Multivariate analysis showed the expected time attributable to a pamidronate infusion to be 110 to 277 minutes compared with 136 to 296 minutes for a zoledronic acid infusion.Conclusion: Use of pamidronate instead of zoledronic acid affords an economic benefit to the NHS. Moreover, published clinical trials show no statistical difference between pamidronate and zoledronic acid at 1 year. Hence, within the limitations of our model and the published evidence, pamidronate is the preferred first-line intravenous bisphosphonate for use in breast cancer patients receiving antineoplastic therapy who are 18 years of age or above and who have at least one bone metastasis (lytic or mixed).

Omega 3 fatty acids for management of CAD reviewed

Omega 3 fatty acids for management of CAD reviewed

Intravesical epsilon aminocaproic acid in management of intractable bladder hemorrhage

Thirty-seven patients with intractable bladder hemorrhage were treated with intravesical epsilon aminocaproic acid (EACH). Radiation cystitis and cyclophosphamide-induced cystitis were the two most common causes of intractable bladder hemorrhage. Thirty-four patients responded to treatment. No side effects were noted. Intravesical EACA appears to be a safe and effective method to control intractable bladder hemorrhage.