Comparative Assessment Of Efficacy Research Articles

Comparative Assessment of Surgical Treatment Results of Patients with Early-Stage Avascular Necrosis of the Femoral Head

Background. The observed sharp increase in patients with avascular necrosis of the femoral head (ANFH) associated with a new COVID-19 infection determines the need to find some new effective strategies for surgical treatment to achieve long-term positive results.
 Aim of the study is to make a comparative assessment of surgical treatment results of patients with early-stage avascular necrosis of the femoral head using different techniques of core decompression and autogenous bone grafting of the femoral head.
 Methods. We performed a comparative analysis of the treatment results of patients with early stages of ANFH. The patients were divided by the treatment method into two groups: control and main. Surgical treatment in the control group (n = 19) consisted of an open decompression and autogenous bone grafting of the femoral head using the Rosenwasser’s “light bulb” technique. The main group (n = 17) included the patients who had undergone the developed combined impaction autografting of the femoral head. Clinical and functional assessment of the treatment results was performed using the Harris Hip Score (HHS) questionnaire and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score. Assessment was performed preoperatively and at 3, 6, and 12 months postoperatively.
 Results. The performed comparative analysis showed statistically significant difference in clinical and functional results after operative treatment in patients of the control and the main groups at all follow-ups. Change of the HHS values presented as Me (Q1;Q3) in patients of both groups at 3, 6 and 12 months was 77.0 (68.0;84.0) and 82.0 (75.0;91.0), p = 0.001; 79.0 (69.0;85.0) and 88.0 (79.0;95.0), p0.001; 81.0 (71.0;86.0) and 90.0 (85.0;92.0), p0.001, respectively. According to the WOMAC, the following dynamics was revealed for the same values: 30.0 (25.0;35.0) and 25.0 (21.0;32.0), p = 0.002; 27.0 (22.0;33.0) and 20.0 (17.0;27.0), p0.001; 24.0 (17.0;30.0) and 15.0 (13.0;24.0), p0.001.
 Conclusion. Comparative assessment of efficacy of the open core decompression with autogenous bone grafting of the femoral head defect using the light bulb technique and closed intralesional resection of necrosis focus with combined impaction grafting of the femoral head showed that the minimal damage to para- and intraarticular tissues when performing the approach to the area of the pathological focus and the main stages of the operation allows to achieve the best clinical and functional results and create optimal conditions for bone remodeling in the grafting area.

Comparative Assessment of Efficacy of Prednisolone and Cyclosporine in Canine Pemphigus Complex

Comparative Assessment of Efficacy of Prednisolone and Cyclosporine in Canine Pemphigus Complex

Comparison of the effect of dietary and herbal supplements on anthropometric, metabolic and androgenic profiles of women with polycystic ovary syndrome: a systematic review and network meta-analysis protocol.

Polycystic ovarian syndrome (PCOS) is characterized by obesity, glucose intolerance, dyslipidemia, and hyperandrogenemia. Although several, placebo-controlled 2x2 factorial design, randomized controlled trials have tested the efficacy of dietary and herbal supplements in controlling these parameters in PCOS patients, these studies are not suitable for a comparative efficacy assessment across these supplements. Herein, a protocol for systematic review and network meta-analysis (NMA) is presented to make such a comparison. PubMed, Embase, and Scopus, were interrogated to identify relevant trials, published in English, factors to be investigated will include dietary factors, micronutrients, choline, essential fatty acids, and herbal extracts. Other factors to be considered include trial design, population characteristics, interventions compared, and outcomes of interest. The revised Cochrane tool was used for the appraisal of eligible trials. NMA (frequentist method) will be used for respective outcomes to compare effect sizes (weighted or standardized mean difference) among the interventions. Both logical and statistical (inconsistency assessment) approaches will be used to minimize intransitivity risk. The surface under the cumulative ranking curve values will be used to gauge the best intervention for outcomes with a statistically significant effect size suggesting a favorable outcome. Additionally, the exploration of interrelation among interventions and the small study effect in respective NMA models will be investigated using network maps and comparison-adjusted funnel plots, respectively. Statistical significance is assumed at p<0.05 with 95% confidence interval. Stata statistical software (v16) was used for analysis. The study was registered with PROSPERO, registration number: CRD42022301530.

Comparative assessment of efficacy and safety of approved oral therapies for overactive bladder: a systematic review and network meta-analysis.

Pubmed, Embase, Web of Science, and the Cochrane Register of Clinical Trials databases were systematically searched. The search time frame was from database creation to June 2, 2022. Randomized controlled double-blind trials of oral medication for overactive bladder were screened against the protocol's entry criteria. Trials were evaluated for quality using the Cochrane Risk of Bias Assessment Tool, and data were statistically analyzed using Stata 16.0 software. A total of 60 randomized controlled double-blind clinical trials were included involving 50,333 subjects. Solifenacin 10mg was the most effective in mean daily micturitions and incontinence episodes, solifenacin 5/10mg in mean daily urinary urgency episodes and nocturia episodes, fesoterodine 8mg in urgency incontinence episodes/d and oxybutynin 5mg in voided volume/micturition. In terms of safety, solifenacin 5mg, ER-tolterodine 4mg, mirabegron, vibegron and ER-oxybutynin 10mg all showed a better incidence of dry mouth, fesoterodine 4mg, ER-oxybutynin 10mg, tolterodine 2mg, and vibegron in the incidence of constipation. Compared to placebo, imidafenacin 0.1mg showed a significantly increased incidence in hypertension, solifenacin 10mg in urinary tract infection, fesoterodine 4/8mg and darifenacin 15mg in headache. Solifenacin showed better efficacy. For safety, most anticholinergic drugs were more likely to cause dry mouth and constipation, lower doses were better tolerated. The choice of drugs should be tailored to the patient's specific situation to find the best balance between efficacy and safety.

A comparative assessment of efficacy and preference between needleless device INJEX and insulin syringe for anesthetizing primary maxillary teeth in children aged 4-9 years: A split-mouth crossover randomized clinical study.

This randomized clinical study included 46 children aged 4-9 years. The patients were digitally allotted to receive 4% articaine for extractions of primary maxillary teeth, either using needleless device INJEX or insulin syringe on each side of the maxillary arch, in two different appointments after a 1-week washout period. Pain perception was measured by the subjective (Faces Pain Scale-Revised [FPS-R]) and objective pain scores (Face, Legs, Activity, Cry, and Consolability [FLACC]) and hemodynamic parameters (heart rate and oxygen saturation) during LA administration and during extractions. After the second appointment, children were asked about their preference between needleless device INJEX and insulin syringe. On evaluating subjective pain scores with FPS-R, intergroup differences between the INJEX and insulin syringe groups were found statistically insignificant, both during LA administration (P = 0.101) and extraction (P = 0.080). However, on assessing pain objectively during extraction using FLACC, the mean pain score was less with insulin syringe (2.78) as compared to INJEX (4.72) and the difference was statistically significant (P = 0.000). There was no significant difference in patient preference between the two methods. Pain perception was minimal during local anesthesia administration using needleless device INJEX; however, its clinical efficacy during extractions was reported to be lower than insulin syringe. Managing pain in children is the most challenging task as it forms the foundation for instilling positive behavior toward dental treatment. Adequate local anesthesia (LA) is the cornerstone of pain management. However, the fear of needles, particularly in young children, can result in complete avoidance and refusal of treatment. This study aimed to evaluate and compare the efficacy and preference between needleless device INJEX and.

Drug Therapy of Cognitive Dysfunction in Minimally Invasive Surgery during Anesthesia with Sevoflurane

The objective: To conduct a comparative assessment of efficacy of Cytoflavin and Cellex for management of cognitive disorders after videolaparoscopic cholecystectomy performed under general inhalation anesthesia with sevoflurane.Results. In three representative groups (n = 30) of patients, markers of inflammation (CRP and IL-6), levels of brain-specific proteins (S-100 and NSE) were studied. Neuropsychological testing were performed by using the MoCA test, frontal dysfunction test battery (FAB) by two stages (stage I ‒ on the eve of the operation, stage II ‒ on the 7th day of the postoperative period). In patients of Group I (n = 30), disorders of higher mental functions of the early postoperative period persisted, which served as the basis for finding ways to eliminate and manage the identified disorders. For this purpose, Cytoflavin was used in Group II (n = 30), and Cellex was used in Group III (n = 30).Comparative characteristics of the level of brain-specific proteins revealed a statistically significant decrease at stage I in Groups II and III versus Group I. The lowest level of both NSE (by 1.45 μg/l, p = 0.041) and S-100 (by 10.1 ng/l, p = 0.044) was observed in Group III versus Group II. In addition, at the second stage of the study, the greatest severity of the inflammatory response was noted in Groups II and III of patients compared to Group I and this degree of severity could be potentiated by the ongoing drug therapy. If in Group I, disorders of higher mental functions persisted on the 7th day of the postoperative period, then as a result of the ongoing drug therapy in Groups II and III, it was possible to achieve significantly better results of neuropsychological testing.Conclusion. Administration of drug therapy contributed to the improvement of higher mental function eliminating cognitive deficit in the early postoperative period.

Assessment of Comparative Efficacy of Disinfectants on the Microbial load of Sheep and Goat Slaughterhouses

Assessment of Comparative Efficacy of Disinfectants on the Microbial load of Sheep and Goat Slaughterhouses

Comparative efficacy assessment of doxycycline and metronidazole gel in managing periodontitis among patients from Hyderabad, Sindh Pakistan.

Objectives: To evaluate the comparative effect of 0.4 % Doxycycline gel and 1% Metronidazole gel as an adjunct to scaling and root planning in the treatment of chronic periodontitis. Study Design: Interventional study. Setting: Department of Periodontology at Isra Dental College, Isra University Hyderabad. Period: October 2017 to April 2018. Material &amp; Methods: A sample of 60 patients of chronic Periodontitis were selected according to inclusion and exclusion criteria through non probability convenience sampling technique. Subjects were divided into 3 groups; GROUP A: Scaling and Root Planning (SRP) + 0.4 % doxycycline gel was applied sub-gingival, GROUP B: Scaling and root planning (SRP) + 1 % metronidazole gel was applied sub-gingival, GROUP C: Scaling and root planning (SRP) alone was performed. Data was recorded on proforma and was analyzed by using SPSS version 22.0. P value significance was taken ≤ or equal to 0.05. Results: Pocket depth at baseline in group A was 4.39± 0.20 which was reduced to 3.78± 0.53 and 3.30 ± 0.17 millimeters at day 10 and after one month respectively. Pocket depth at baseline in group B was 4.45± 0.19 which was reduced to 3.89± 0.51 and 3.34 ± 0.17 millimeters at day 10 and after one month respectively. Pocket depth at baseline is group C was 4.45± 0.18 which was reduced to 4.10± 0.20 and 4.06 ± 0.27 millimeters at day 10 and after one month respectively. Pocket depth at Day 10 in groups A, B and C showed statistically significant. Conclusion: Both Doxycycline and Metronidazole gel proved same efficacy when compared to control group. Since there is no difference in efficacy of doxycycline and metronidazole gels when applied in patients having periodontitis.

A COMPARATIVE STUDY OF EFFICACY ON GLYCEMIC CONTROL BY GLIMEPIRIDE VERSUS TENELIGLIPTIN AS AN ADD ON TO METFORMIN THERAPY IN TYPE 2 DIABETES MELLITUS PATIENTS

Objective: In our study, the objective was to evaluate the effectiveness of glycemic control of Glimepiride versus Teneligliptin for 2nd-line therapy in combination with Metformin in T2DM patients.&#x0D; Methods: A Randomized, Observational, Prospective study has been conducted in outpatient and inpatient departments of General Medicine in RVM Hospital (Laxmakkapally, Mulugu, Siddipet, Telangana). A total of 100 patients with T2DM were recruited in our study in which 50 patients were in Group A (Metformin-Glimepiride) and the other 50 patients were in Group B (Metformin-Teneligliptin). The comparative assessment of efficacy was conducted using glycemic parameters such as FBS, PPBG and HbA1c to interpret the results.&#x0D; Results: The mean difference values of HbA1c pre-treatment and post-treatment of Group A were calculated as 1.47 and of Group B was 0.83. The mean difference values FBS pre-treatment and post-treatment of Group A were found to be 56.96 and Group B was 29.62. The PLBS mean difference at Pre-treatment and Post-treatment of Group A and Group B was obtained to be 115.8 and 52.58, respectively.&#x0D; Conclusion: From the results obtained, we hereby conclude that, though there was no large difference between the lowering of HbA1c values by two Groups, the FBS and PLBS levels were diminished significantly by Group A (Metformin-Glimepiride) than Group B (Metformin Teneligliptin). Therefore, Glimepiride is considered to be more beneficial than Teneligliptin when combined with Metformin Monotherapy.

Comparative assessment of efficacy and immunogenicity of Gam-COVID-Vac and CoviVac vaccines against SARS-CoV-2

<h3></h3> Медицинское сообщество интересует продолжительность иммунной защиты, а также уровень специфических антител (АТ), способных предотвратить повторную инфекцию, вызванную SARS-CoV-2. <h3>ЦЕЛЬ ИССЛЕДОВАНИЯ</h3> Выполнить<b></b> сравнительную оценку эффективности и иммуногенности вакцин «Гам-КОВИД-Вак» и «КовиВак» против вируса SARS-CoV-2 в рамках проспективного наблюдательного исследования. <h3>МАТЕРИАЛ И МЕТОДЫ</h3> В процессе вакцинации лиц (<i>n</i>=3322) в возрасте 18 лет и старше использованы следующие вакцины: «Гам-КОВИД-Вак» — 1622 (48,8%) человека (I группа), «КовиВак» — 1700 (51,2%) человек (II группа). Наблюдение за вакцинированными проводилось на протяжении 6 визитов исследования: перед введением 1-го компонента вакцины, перед введением 2-го компонента, а также через 42 дня, 3 мес, 6 мес и 12 мес после введения 1-го компонента вакцины. Сравнивали уровни иммуноглобулина G (IgG) АТ к S-белку после введения вакцин «Гам-КОВИД-Вак» и «КовиВак» путем иммуноферментного анализа. Для статистической обработки результатов применяли программы IBM SPSS Statistics v. 24 и MedCalc v. 20.104. <h3>РЕЗУЛЬТАТЫ</h3> У лиц I группы отмечено увеличение уровня специфических АТ (IgG) к S-белку коронавируса SARS-CoV-2 от визита 1 к визитам 2 и 3 (<i>p</i>&lt;0,05). В более отдаленные сроки наблюдения (визиты 5, 6) уровень АТ у исследуемых I и II групп существенно не различался, причем оставался достаточно высоким к визиту 6. На протяжении года наблюдения у лиц, вакцинированных «Гам-КОВИД-Вак» (I группа), статистически значимо (<i>p</i>&lt;0,01) реже встречалась подтвержденная методом полимеразной цепной реакции инфекция COVID-19 — у 22,2% по сравнению с 45,2% у лиц, вакцинированных «КовиВак» (II группа). Максимальное количество дней (<i>p</i>&lt;0,05) до развития инфекции COVID-19 отмечено у лиц, вакцинированных «Гам-КОВИД-Вак» (221 день), по сравнению с лицами, вакцинированными «КовиВак» (159 дней). <h3>ЗАКЛЮЧЕНИЕ</h3> Применение вакцины «Гам-КОВИД-Вак» является более эффективным в отношении развития инфекции COVID-19, а также характеризуется быстрым ответом гуморального звена иммунитета по сравнению с вакциной «КовиВак». В то же время обращает на себя внимание факт примерно одинаковой продолжительности гуморального иммунного ответа на фоне применения вакцин «Гам-КОВИД-Вак» и «КовиВак».

Comparative Study of Efficacy of Kutaja Beeja Churna and Ayurvedic Herbal Compound in the Management of Mutrashmari (Urolithiasis)- A Research Protocol

Introduction: Acharya Sushruta, the father of surgery has included Ashmari in Astamahagada due to its fatal nature. “Ashman” the Sanskrit word, literally means “structure resembling stone”. While the word ‘Ari' means ‘enemy,' so it refers to a sickness in which stones grow and inflict intense pain, as if caused by an adversary. Mutrashmari can be associated with Urolithiasis which is the third most common affliction of the urinary tract. Acharya Sushruta has described medicinal treatment in the initial stage of the disease and advised that surgery to be done only on failure of conservative treatment and when death becomes inevitable if not operated. In Yogaratnakar, Ashmari chikitsa, Kutaja is described to be more effective in the treatment of Mutrashmari. Need of study: In modern medicine, the treatment of urinary stones is non surgical as well as surgical interventions but both have some limitations and also stone formation reoccurs after removal. There is a need for safe, cost effective and simple method of management of urolithiasis which is curative as well as preventive. Aim: Comparative assessment of efficacy of Kutaja Beeja Churna and Ayurvedic Herbal Compound in the management of Mutrashmari (Urolithiasis). Materials and Methods: A randomised control trial (single blind parallel) with 1:1 ratio on 2 groups and will be conducted in Mahatma Gandhi Ayurved College Hospital and Research Centre Salod (Hi) Wardha. Expected duration of the study is one and half year (February 2022 - August 2023). Approval from the Institutional Ethical Committee has been taken and for this trial the registration number is CTRI/2021/09/036297. For statistical analysis Wilcoxon signed-rank test, Mann Whitney U test, Student’s t-test and the Statistical Package for the Social Sciences (SPSS) software will be used in the study. After doing drug analysis, a total of 60 patients fulfilling the inclusion criteria will be selected and distributed in two groups having 30 each. In group A, Kutaja Beeja Churna and in group B, Ayurvedic Herbal Compound will be given twice a day for 45 days. Assessment will be done on day 15, 30 and 45 and after the intervention; follow-up will be taken on days 60 and 90. Results will be drawn from the observations of subjective parameters like pain and dysuria and objective parameters like size of the stone, site of the stone and haematuria.

Comparative assessment of efficacy of artery ligation versus rubber band ligation for management of haemorrhoids in Southern Rajasthan

Background: One of the commonest complaints presenting in the surgical out patient department (OPD) is haemorrhoids. Commonest types of haemorrhoids are grade II and III. There is a wide number of modalities that can be adopted for their management. It depends on the skill of the surgeon and preferences of the patient. The present study was designed to ascertain if two modalities of artery ligation and band ligation are comparatively equal or not in managing symptomatic grade II and III haemorrhoids in Rajasthan.Methods: The study comprised of 100 subjects who were randomly divided in two groups based on the procedure to be followed. The subjects were told about the study and its objective.Results: The observations reported that among the selected study population there were more relapses in band ligation as compared to artery ligation.Conclusions: This led to the conclusion that despite its painful and traumatic methodology, haemorrhoid artery ligation still provides a better outcome.

First assessment of comparative efficacy of virtual bronchoscopy and radial endobronchial ultrasound for minimally invasive diagnosis of peripheral pulmonary lesions

Data regarding the efficacy of virtual bronchoscopy (VB) compared to radial endobronchial ultrasound (rEBUS) for minimally invasive diagnostics of peripheral pulmonary lesions (PPLs) are still controversial.Aim. To assess the comparative efficacy of VB versus VB plus rEBUS in patients with PPLs.Methods. The study enrolled 36 subjects with PPLs detected by chest high resolution computed tomography (HRCT). All patients had bronchoscopy with various biopsy methods (based on navigation) alone or in combination with each other, followed by cytological, histological (if the biopsy sample was available), and microbiological analysis of the specimens. The subjects were randomized into two groups depending on the navigation technique: VB + rEBUS group (I) and VB group (II). VB (Osirix) was done as a planning procedure before real bronchoscopy with rEBUS navigation (Olympus UM-S20-17S) in group I. In group II VB was the only navigation technique.Results. Overall diagnostic yield (d. y.) reached 60% and 56% for groups I and II, respectively. In group I, the d.y. reached 86% for malignancy and 42% for other benign diseases. In group II, the d.y. reached 100% for malignancy and 36% for other benign diseases. The navigation efficacy was higher in the presence of a draining bronchus sign according to chest HRCT, lesion size more than 20 mm, upper lobe peripheral lesion. In group I, detecting the lesion with the ultrasound radial mini probe was also a predictor of efficacy. In group II, abnormal intraluminal bronchial anatomy according to VB as a sign of central lung cancer was also a predictor of efficacy.Conclusion. Both rEBUS and VB are safe and effective navigation techniques that provide for highly effective minimally invasive diagnosis of PPLs. VB could be a sound alternative when rEBUS is unavailable.

Comparative assessment of efficacy and toxicity of R-DA-EPOCH and R-mNHL-BFM-90 induction courses in the treatment of patients with diffuse large B-cell lymphoma with poor prognostic factors in a randomized multicenter clinical trial “DLBCL-2015”

Background. Diffuse large B-cell lymphoma (DLBCL) is one of the most common and aggressive tumors of the lymphatic system. Despite the frequency of occurrence, there is no single algorithm for treating DLBCL patients with poor prognostic factors. R-CHOP therapy does not allow achieving long-term complete remissions. Therefore, there is a need for second and subsequent lines of therapy. At the same time, the effectiveness of each subsequent therapy is low, while the toxicity increases. There are many randomized trials of the DLBCL treatment; however, there are only a few studies on the comparative efficacy of high-dose chemotherapy at the induction stage.The objective of the study: the evaluation of the effectiveness and toxicity of R-DA-EPOCH and R-mNHL-BFM-90 induction courses in DLBCL patients with poor prognostic factors in a randomized multicenter clinical trial “DLBCL-2015”.Materials and methods. As of April 2021, 140 patients from 13 medical institutions in Russia were included in the randomized multicenter clinical trial DLBCL-2015. As part of this study, the analysis of pharmacoeconomic factors and effectiveness of combined immunochemotherapy R-DA-EPOCH and R-mNHL-BFM-90 in patients with prognostically unfavorable DLBCL had been performed. From January 2018 to April 2021, this study included 41 patients (21 men, 20 women) with a newly diagnosed DLBCL, with 2 or more factors of an unfavorable prognosis, who were treated at the National Research Center for Hematology of the Ministry of Health of the Russian Federation. Of these, 21 patients received R-DA-EPOCH, and 20, R-mNHL-BFM-90 therapy. Median age for R-DA-EPOCH patients was 52 years (range 30–64); for R-mNHL-BFM-90 patients, 40 years (range 18–60). All patients had high-intermediate and high risk according to the international (IPI) and age-adjusted (aaIPI) prognostic index. The primary protocol endpoints were rates of complete remission, partial remission, disease progression, and hematologic and non-hematologic toxicity. Side effects were assessed in accordance with the Common Terminology Criteria for Adverse Events (CTCAE) criteria.Results. By the end of 6 induction courses, the frequency of achieving complete remission on R-mNHL-BFM-90 therapy was 100 % (20/20) compared to R-DA-EPOCH, where the complete remission rate was 71.4 % (15/21) (p = 0.0097), partial remission and progression were 14.3 % (n = 3) and 14.3 % (n = 3), respectively. Hematological toxicity on therapy according to the R-mNHL-BFM-90 scheme exceeded that on R-DA-EPOCH in terms of myelotoxic agranulocytosis (p = 0.0536), anemia (p = 0.0464) and thrombocytopenia grade III–IV (p = 0.0206). When assessing non-hematological toxicity at the compared courses, no statistically significant differences were noted, all complications occurred with the same frequency.Conclusion. Treatment according to the R-mNHL-BFM-90 protocol is highly effective as first line therapy in high-intermediate and high-risk DLBCL patients. The hematologic toxicity is higher on the R-mNHL-BFM-90 than on the R-DA-EPOCH therapy, but it is acceptable. Non-hematological toxicity in both programs is comparable.

Comparative assessment of spray nozzles efficacy in the control of fusarium head blight in the barley crops using developed quantitative PCR assay

Fusarium species infect cereal spikes during anthesis and cause Fusarium head blight (FHB), a destructive disease of cereal crops with worldwide economic relevance. The necessity for these phytopathogenic fungi effective control becomes increasingly important for the production of both cultivated plants and those plants seeds. Fungicide application is a key methodology for controlling the disease development and mycotoxin contamination in cereals. Polymerase chain reaction (PCR) is currently the most commonly admitted DNA-based technology for specific, rapid and precise Fusarium detection. We have developed and patented the method for detection and quantitative determination of phytopathogenic fungi F. avenaceum and F. graminearum in plant seeds using Real-Time PCR with a pair of primers, designed to amplify sequences of the internal transcribed spacer at the ribosomal RNA gene cluster of those phytopathogenic fungi. This study was aimed to perform a comparative assessment of the efficacy of different spray nozzles for antifungal treatment to control F. avenaceum and F. graminearum infection of barley grains using a developed qPCR diagnostic system. A single application of a fungicide (active ingredient's content: 250 g/l propiconazole, 80 g/l cyproconazole) at BBCH 65 (middle of flowering) was carried out. For this purpose, four spray nozzles with different technical characteristics were used: Flat Fan 030, Amistar 030, Defy 3D 030 and Vegetable 060 (Pentair, USA). DNA-based fungi detection and identification was performed using conventional PCR and developed qPCR. The level of mycotoxins in barley grain was determined using enzyme-linked immunosorbent assay (ELISA). Grain count in the ear of barley and thousand seed weight (TSW) were also examined.&#x0D; A single application of the fungicide inhibited the development of FHB and is accompanied by the slight increase of TSW values in treated plants. It was found, that the most effective fungicide was against F. avenaceum and F. graminearum. The inhibitory effect depended on sprayer type. According to qPCR results, the best performance was achieved when using Amistar 030 and Flat Fan (FF) 030 sprayers. The average concentration of deoxynivalenol (DON) content in all barley grain samples were up to 4 times higher than the permissible level. Overall, because of the high contamination levels, found in tested samples, it is possible to state that a single application of the fungicide at the flowering phase was not able to effectively reduce DON contamination in barley samples.&#x0D; The developed test-system for qPCR provides new important information in the study of the effectiveness of fungicides and development of strategies to control FHB in cereals, not achievable with conventional PCR.

Comparative assessment of efficacy and safety of ambrisentan and bosentan in patients with pulmonary arterial hypertension: A meta-analysis.

Two endothelin receptor antagonists, ambrisentan and bosentan, have been demonstrated to be effective individually compared with placebo in the treatment of patients with pulmonary arterial hypertension (PAH). This network meta-analysis compared the efficacy and safety of ambrisentan and bosentan in patients with PAH. Clinical trials were identified from the Cochrane Central Register of Controlled Trials (CENTRAL/CCTR), EMBASE and PubMed databases. Weighted mean differences (MD) with 95% confidence intervals (CI) were calculated for continuous outcomes (6-min walk distance [6MWD] and Borg dyspnoea index [BDI]). Hazard ratio (HR) was calculated for binary outcomes, including clinical worsening, discontinuation due to adverse events (AEs) and liver dysfunction. Surface under cumulative ranking curve (SUCRA) was used to rank the treatments in each index. Five clinical trials from four published studies (total patients: n=920) were included. Ambrisentan and bosentan showed no significant difference in 6MWD (MD: -1.32; 95% CI: -27.87, 25.31, SUCRA score: ambrisentan 0.73, bosentan 0.77), BDI (MD: -0.16; 95% CI: -0.98, 0.65, SUCRA score: ambrisentan 0.83, bosentan 0.66), clinical worsening (HR: 0.99; 95% CI: 0.33, 2.94, SUCRA score: ambrisentan 0.75, bosentan 0.74) and discontinuation due to AEs (HR: 0.84; 95% CI: 0.11, 5.86, SUCRA score: ambrisentan 0.47, bosentan 0.57). However, ambrisentan was significantly better than bosentan with respect to abnormal liver function (HR: 23.18; 95% CI: 2.24, 377.20, SUCRA score: ambrisentan 0.99, bosentan 0.02). The results of this network meta-analysis suggest that ambrisentan was similar to bosentan in efficacy, while it exhibited better tolerability with respect to abnormal liver function in comparison with bosentan, in patients with PAH.

English

BACKGROUND Managing pain and stress during and after any surgical procedure is a real challenge and a matter of concern for both surgeons and anaesthesiologists. Various analgesics like tramadol and nalbuphine have been used as adjuncts to anaesthetic agents with different efficacy. We wanted to do a comparative assessment of efficacy between intravenous (IV) administration of tramadol and nalbuphine in managing perioperative pain and stress. METHODS This was a single blinded randomised control trial, which included 60 female adult patients in the age group of 30 - 50 years who were posted for surgical procedures like elective vaginal hysterectomy under spinal block. Patients with comorbidities like diabetes, obesity, hypertension, impaired pulmonary function, recent history of medication with selective serotonin reuptake inhibitors were excluded from the study. Study participants were divided into two groups - group tramadol (TR) and group nalbuphine (NA) with 30 patients in each group. Group TR was given tramadol 0.5 - 0.7 mg / Kg whereas group NA was given nalbuphine 0.1 - 0.2 mg / Kg after an hour of spinal block. Both drugs were administered intravenously. Midazolam 0.01 - 0.05 mg / Kg was administered intravenously within first hour of surgery for sedation. Pain, stress and sedation score, requirement of rescue analgesics and occurrence of adverse drug reactions (ADRs) over 12 hours postoperatively were compared. RESULTS Significant lowering of pain and stress scores and higher sedation score was observed in group NA in comparison to group TR. The requirement of rescue analgesic and occurrence of side effects like nausea and vomiting were less in group NA. CONCLUSIONS Intravenous administration of nalbuphine was found to be more effective in perioperative control of pain and stress and can be a better choice than intravenous tramadol. KEYWORDS Efficacy, Tramadol, Nalbuphine, Rescue Analgesia

Comparative efficacy assessment of antiviral alone and antiviral-antibiotic combination in prevention of influenza-B infection associated complications

ABSTRACT Objective The study aimed to compare the efficacy of antiviral drug alone and antiviral-antibiotic combination therapy in prevention of complications associated with influenza B hospitalized patients. Method Laboratory confirmed influenza B hospitalized patients presented in emergency room after 48 hours of symptoms onset were identified and divided into two groups; Group-1 patients were initiated on Antiviral drug (oseltamivir) alone while Group-2 patients were initiated on Antiviral drug (oseltamivir) in combination with Antibiotic for at least 3 days. Patients were evaluated for different clinical outcomes among both treatment group. Results A total of 153 and 131 patients were identified for Group-1 and Group-2, respectively. Clinical outcomes such as secondary bacterial infections (20.9%-vs-9.1%; P = 0.031), need of respiratory support (28.7%-vs-12.9%; P = 0.002), length of hospitalization stay (6.57-vs-4.95 days; P = <0.001), incidences of ICU admission (15.7%-vs-7.6%; P = 0.036), early clinical failure (32.6%-vs-16.1%; P = 0.01), and time to clinical stability (4.83-vs-4.1 days; P = 0.001) were found to be statistically less significant (P-value <0.05) for Group-2 patients. Conclusion Early initiation of antibiotic therapy in combination with oseltamivir was found to be more efficacious than oseltamivir alone in prevention of influenza B-associated complications especially in high-risk influenza patients.

Comparative assessment of efficacy of various anesthesia options after cesarean section

The article describes the comparative assessment of efficacy of transversus abdominis plane block as a component of multimodal analgesia during cesarean section.Subjects and methods. 165 primiparous women were enrolled into the study, their average age made 30.5 years. Operative delivery was performed under spinal anesthesia. All patients were divided into five groups. In the patients in Groups 1 and 3, postoperative analgesia was performed using transversus abdominis plane (TAP) block without ultrasound guidance, while in Groups 2 and 4, TAP block was guided by ultrasound. In Groups 1 and 2, ropivacaine hydrochloride was used at a concentration of 0.2%, in Groups 3 and 4 - 0.375%. In Group 5, paracetamol in combination with narcotic analgesics was used for analgesia. Pain intensity was assessed every hour using a visual analogue pain scale at rest and during movement during the 1st day after delivery. To assess the severity of the stress response and metabolic status of patients, concentrations of cortisol, prolactin and glucose in blood plasma was tested. The levels of cortisol and prolactin were tested in 4 stages: before surgery, 1 hour after surgery, 6 and 24 hours after delivery. Plasma glucose was tested in 3 stages: before surgery, 1 hour and 6 hours after surgery.Results. TAP block in combination with paracetamol provided adequate postoperative analgesia, reduced the consumption of analgesics, and also contributed to the earliest activation of new mothers after cesarean section. The use of 0.2% ropivacaine hydrochloride solution with TAP block was equally effective as the use of 0.375% solution of ropivacaine hydrochloride. Ultrasound guided TAP block significantly improved the quality of postoperative pain management. TAP block reduced the level of stress hormones in patients but in 24 hours, the levels of stress hormones in all groups of patients receiving and not receiving TAP block did not differ.

Autoarterial remodeling of the common carotid artery bifurcation in treatment of stenotic lesions

Carotid endarterectomy is the main operation carried out for prevention of ischaemic stroke in haemodynamically significant stenoses of the bifurcation of the common carotid artery. Despite the literature data demonstrating some advantages of eversion carotid endarterectomy over the classical technique there arises a series of complicated, as yet unsolved problems. This concerns the control of the distal portion of an atherosclerotic plaque in prolonged lesions of the internal carotid artery, the absence of a temporary bypass graft, necessity of prosthetic repair of the internal carotid artery in detachment of the distal border of the plaque. We suggested a new technique of carotid endarterectomy making it possible to widen visual removal of atheromatous masses from the internal carotid artery, to improve the control of the distal portion of the plaque in a prolonged lesion of the internal carotid artery. We carried out a comparative assessment of efficacy and safety of the new method of carotid endarterectomy versus the classical variant in a randomized study. The proposed technique of carotid endarterectomy turned out to be compatible by safety and demonstrated similar results with the classical carotid endarterectomy by the number of ischaemic strokes, transitory ischaemic attacks, and myocardial infarctions in the early and remote postoperative periods. When comparing the groups by efficiency, the primary efficacy endpoint, including cases of restenosis >50% according to the findings of ultrasonographic examination of the brachiocephalic arteries, all cases of ischaemic events (acute impairments of cerebral circulation, transitory ischaemic attacks), as well as the presence of the clinical picture of cranial nerve paresis demonstrated a significant advantage of the new technique versus the comparison group at the expense of a lower incidence of restenoses in the area of the operation during the whole period of follow up. In the group of autoarterial remodelling, the composite endpoint of outcomes occurred in 6 patients (6.1%) and in the group with the classic carotid endarterectomy - in 19 (19.6%) patients, p=0.005.