End Of First Month Research Articles

Cyanoacrylate vs. sutures in clean and clean-contaminated surgical wounds - a randomised control study.

Various techniques of closure of surgical incisions have been described ranging from various suture materials, staples and tapes to adhesive compounds. Cyanoacrylate is an adhesive compound available for surgical incision closure. Although sutures have been the preferred universal choice for surgical incision closure, glue is gaining popularity in specific places like pediatric injuries, facial injuries, laparoscopic incision closure, etc. This study aimed to compare the results between the application of cyanoacrylate and conventional suturing. In this randomized control study, patients were divided into two groups of 100 each. The surgical incisions were closed using cyanoacrylate glue in Group A patients and polyamide (EthilonTM 2-0) in Group B patients. Post-operative pain was assessed using Visual Analogue Scale on the first, third, and seventh day. The wounds were evaluated for complications on post-op days 1, 3, 7, and 30 using the ASEPSIS score. Cosmetic outcome was assessed at the end of first month using the Modified Hollander Cosmesis Scale. Post-operative pain was significantly less in the glue group on days 1, 3, and 7. Wound infection with dehiscence occurred in 4 cases (4 %) in Group A and one patient (1 %) in Group B, which was statistically insignificant. There was no significant difference in cosmetic outcomes in either Group. Cyanoacrylate is a good alternative to sutures in skin closure of clean and clean-contaminated surgical wounds.

A novel marker for predicting type 1 retinopathy of prematurity: C-reactive protein/albumin ratio.

We aimed to investigate whether the C-reactive protein (CRP) to albumin ratio (CAR) an inflammatory predictor can be used as a marker for the development of ROP. Gestational age, birth weight, gender, neonatal, and maternal risk factors were recorded. The patients were divided into two groups: those who did not develop ROP (ROP -) and those who developed ROP (ROP +). The ROP + group was further separated into two groups: those who required treatment (ROP + T) and those who were not treated (ROP + NT). The following parameters were noted in the first postnatal week and at the end of the first postnatal month: CRP, albumin, CAR, white blood cell (WBC), neutrophil, lymphocyte, neutrophil-to-lymphocyte ratio (NLR), distribution red cell width (RDW), platelet (Plt), and RDW/platelet ratio. We evaluated 131 premature infants who met the inclusion criteria. There was no difference between the main groups in hemogram parameters and CAR at the postnatal first week. WBC count (p = 0.011), neutrophil count (p = 0.002), and NLR were high (p = 0.004) in the ROP + group at the end of the postnatal 1st month. The CAR level at the end of the first month was higher in the ROP + group (p = 0.027). CAR was similar between the ROP + T and ROP + NT groups (p = 0.112) in the postnatal first week but higher in the treatment-required group at the end of the first month (p < 0.01). High CAR and high NLR at the end of the postnatal first month can be used to predict the development of severe ROP.

Body Weight Performance, Egg Production and Egg Quality Trait of Lohmann Chicken Genotype in Wachemo University Poultry Farm under Intensive Management System

Aim: This study was conducted to evaluate body weight performance, egg production and egg quality traits of Lohmann chicken genotype in Wachemo University.&#x0D; Methodology: For the experiment, the Lohmann layer chicken in the University farm was used and SAS ver 9.4 was used to analyze the data. Body weight and egg production progress were evaluated at different times. A total of 200 eggs (100 at the end of 1st month and 100 at the end of 3rd month of egg lay) were brought to Hawassa University poultry farm laboratory to assess the egg quality traits. For the data analysis, SAS (Ver. 9.4) was used.&#x0D; Results: The Lohmann chickens weighed 0.93kg at their entry to the university poultry farm and increased in to 1.34kg at end of first month of entry. In the farm, about 34.4%, 42.5% and 58.6% of the hens have laid egg until the end of first, second and third months of egg lay respectively; this indicates that the increasing trend of egg production of Lohmann chickens as age increase. Egg laying age difference has a significant effect (p&lt;0.05) on egg weight, egg length, egg width, shell thickness, egg surface area and shell ratio. There was a significant difference in yolk weight, yolk diameter, albumen ratio and yolk index for the eggs collected from the Lohmann chickens at different age. Egg weight has the strong and positive correlation with egg length (78.6%), egg width (84.7%) and egg surface area (99.8%). Albumen weight is more correlated with albumen ration (64.2%) positively and yolk albumen ration (65.6%) negatively.&#x0D; Conclusion: Poultry production could be influenced by many factors. Among the factors, age was evaluated in the current study; as age increased, the growth performance, egg production and egg quality traits improved.

Maternal and Fetal Outcome in Pregnant Women With Critical COVID-19 Treated With Tocilizumab in a Tertiary Care Hospital in Dubai.

Pregnancy, complicated by coronavirus disease 2019 (COVID-19), results in higher hospitalization and mortality rate. Pathogenesis of COVID-19 is similar to any other systemic inflammatory condition but results in a cytokine storm ofhigher magnitude causing severe acute respiratory distress syndrome and multiorgan failure. Tocilizumab, a humanized monoclonal antibody, targets soluble and membrane-bound IL-6 receptors and is used in the treatment ofjuvenile idiopathic arthritis, rheumatoid arthritis, and cytokine release syndrome. However, studies exploring itsrole in pregnancy are minimal. Hence, this study was done to study the effect of tocilizumab on maternal and fetal outcomes incritical COVID-19 pregnant women. A retrospective study was conducted on 28 pregnant women with critical COVID-19 who received tocilizumab. Clinical status, chest x-ray, biochemical parameters, and fetal well-being were monitored and documented. The discharged patients were followed up through telemedicine. On treatment with tocilizumab, improvement was seen in thenumber of zones and patterns of chest x-ray, along with 80% reduction in the c-reactive protein (CRP) levels. Based on the WHO clinical progression scale, 20 patients improved by theend of first week, and by the end of first month, 26 patients became asymptomatic. Two patients died during thecourse of the disease.No fetal adverse effects were noted. Based on the encouragingresponse and as tocilizumab did not impartany adverse effects on the pregnancy, tocilizumab may be administered as an adjuvant to criticalCOVID-19 pregnant women in their second and third trimesters.

Long-term prophylactic efficacy of transcranial direct current stimulation in chronic migraine. A randomised, patient-assessor blinded, sham-controlled trial

ObjectiveTo assess the prophylactic effect of anodal tDCS of the left motor cortex in patients with resistant chronic migraine (CM) and its long-term maintenance. MethodsIn a patient-assessor blinded, sham-controlled trial, 36 patients were randomized to receive anodal tDCS (active group, n = 18) or sham tDCS (sham group, n = 18). The studied population was characterized by a previous failure of at least 3 classes of preventive drugs and a mean duration of migraine history of 26 years. The tDCS procedure consisted of an induction phase of 5 consecutive daily sessions (week 1) followed by a maintenance phase of 1 weekly session during the next 4 weeks and two bimonthly sessions in the next month, for a total of 11 sessions during 2 months. Anodal tDCS was delivered at 2 mA intensity for 20 min over the left motor cortex. The primary endpoint was the reduction in the monthly number of migraine attacks from baseline to each period of follow-up (months 1, 2, 3, 5) between the active and sham groups. ResultsThe monthly number of migraine attacks expressed as the percentage of reduction from baseline was significantly reduced in the active versus the sham group, from the end of first month (−21% ± 22 vs. −2% ±25, p = 0.019) to the end of follow-up (3-month post-treatment) (−32% ± 33 vs. −6% ±39, p = 0.011). At this time, the rate of responders, defined as a reduction of the monthly number of migraine attacks ≥30% from baseline, was significantly higher in the active group than in the sham group (50% vs. 14%, p = 0.043). ConclusionOur results show a marked prophylactic effect of anodal tDCS of the left motor cortex in resistant CM extending several months after the stimulation period, and suggest that this neuromodulatory approach may be part of the prophylactic alternatives available for CM.

Impact of insulin-like growth factor 1, immunoglobulin G and vitamin A in colostrum on growth of newborn Black Bengal goats and its crossbred.

The study aims to investigate the relationships between colostral concentrations of insulin-like growth factor 1 (IGF-1), immunoglobulin G (IgG) and vitamin A (Vit A) and growth (body weight and average daily gain) in Black Bengal (BB) and its crossbred. The colostrum from dams (n=16) was collected at parturition to measure the concentrations of IGF-1, IgG and Vit A. The kid weight at birth (W-0), day 14 (W-14) and day 28 (W-28) were measured and the average daily gain during day 1-14 (ADG1-14) and day 14-28 (ADG14-28) were calculated. The average concentrations of IGF-1, IgG and Vit A in colostrum were 504.6±74.9ng/ml, 9.7±0.6mg/ml and 549.1±72.5µg/100g, respectively. The average body weight of kids at birth, day 14 and 28 were 1.72±0.08, 2.95±0.11 and 3.94±0.13kg respectively. Kid's breed, IGF-1, IgG and Vit A had significant positive effects on ADG14-28 while parity, litter size and sex had no effect. The growth factors that were classified into 2 classes based upon the mean values of colostral contents in all kids showed that the kids receiving the higher concentrations of IGF-1, IgG and Vit A in colostrum had higher body weight gain than those receiving the lower concentrations (92.1±7.8 vs. 59.8±5.7g/day; p=0.002, 88.3±7.8 vs. 60.3±6.1g/day; p=0.009 and 91.1±6.8 vs. 56.7±5.8g/day; p<0.001 respectively). It is concluded that IGF-1, IgG and Vit A concentrations in colostrum of dams were associated with increased kid's body weight gain at the end of first month in BB and BB crossbred goats.

The effect of fascia and free skin graft on the healing of mastoid cavity after canal wall down mastoidectomy.

Post-mastoidectomy delayed cavity healing is a challenge to manage. This study aimed to cut down healing time with a simple technique (fascia with a skin graft) and compared it with controls without this technique. The current study was a prospective non-randomised controlled study, conducted in a tertiary referral hospital. Thirty cases and 30 controls with squamosal type chronic otitis media were studied. By the end of first month, 23.3 per cent of cases had healed compared with 3.3 per cent of controls. At the third month follow up, 83.3 per cent of cases and 53.3 per cent of controls had healed. At the sixth month follow up, 93.3 per cent of cases and 86 per cent of controls had healed. Healing of the mastoid cavity, as evidenced by epithelialisation and formation of a dry cavity, was faster in cases that received the graft when compared with controls without the graft.

The effect of brace treatment on pulmonary functions in adolescent idiopathic scoliosis: An 8-month follow-up study.

The instant effect of a brace on pulmonary functions of patients with adolescent idiopathic scoliosis (AIS) is known. However, the permanent effects of its regular use are still unclear. This study aimed to determine whether a brace in patients with AIS had a permanent effect on respiratory functions. Fifteen patients with a mean age of 13.2 ± 1.6 years, and a major Cobb angle of 25.8∘± 7.7∘ participated in this study. Lung volumes and respiratory muscle strength were measured with and without thoracolumbosacral brace, at the end of first month and follow-up period after the patients started using the brace for 23 hours daily. When the brace was on, the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1/FVC, peak expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity values were found to be lower at both first month and follow-up. After the follow-up, the measurement results did not differ from the results of the first month. The brace had a momentary restrictive effect on patients with AIS. However, it did not cause a permanent change in pulmonary functions after the 8-month follow-up.

Chronology of cardiac dysfunction after permanent pacemaker implantation: an observational 2\xa0year prospective study in North India

BackgroundThe purpose of this study is to evaluate cardiac functions using transthoracic echocardiography, change in lead parameters and electrocardiogram (ECG) morphology in patients undergoing permanent pacemaker implantation over a follow-up period of 6 months.MethodsThis is a prospective study in patients undergoing permanent pacemaker implantation in a tertiary care hospital. Patients undergoing permanent pacemaker implantation were enrolled for up to one year and Echocardiographic parameters (by 2 blind operators) and ECG parameters were recorded at admission (within 24 h), before discharge (within 7 days of pacemaker implantation), after 1 month (± 7 days) and after 6 months (± 7 days) of follow-up.ResultsA total of 96 patients (60.4% males and 39.6% female, mean age 66.65 years) were implanted with permanent pacemaker. The mean QRS duration was 133.18 ms and increased significantly to 146.03 ms by 6 months despite septal lead placement in majority (92%) of patients. The mean baseline ejection fraction of 51.47 decreased significantly to 47.83 by 6 months. Diastolic parameters like left atrial volume index, early to late diastolic transmitral flow velocity (E/A) and early diastolic mitral annular tissue velocity (E/e′) showed a significant increase (> 5%) from baseline by the end of first week. By the end of first month, systolic dysfunction of RV sets in with significant (> 5%) change from baseline in parameters like Right ventricle myocardial performance index, transannular plane systolic excursion and right ventricle systolic excursion velocity (RVS′).ConclusionWe have observed that pacemaker recipients with baseline reduced left ventricle (LV) systolic functions perform significantly worse compared to those with baseline normal cardiac functions and had a higher rate of deterioration of LV function. RV dysfunction is the first abnormality that occurs, by 1 week followed by LV dysfunction which starts by 1 month and the diastolic dysfunctions precede the systolic dysfunction. QRS duration also showed a gradual increase despite septal lead placement in majority (92%) and lead parameters showed no significant change over 6 months.

T-cell Subset Profile in Kidney Recipients of Extended or Standard Donors

The usage of extended-criteria donors (ECD) became a routinely accepted manner in the last decade. ECD is a potential risk factor for antibody-mediated rejection. Analysis of lymphocyte subsets might be a complementary diagnostic toolkit because there is limited knowledge about this term. Between May 12, 2016, and September 4, 2019, a total of 130 patients who had undergone kidney transplant were investigated. Patients were divided in ECD and standard criteria donor (SCD) groups. Blood samples were collected before the operation, then in the first week and after 30, 60, 180, and 365 days. Besides routine laboratory tests, multicolor flow cytometry was performed for lymphocyte subsets. ECD grafts were transplanted to older recipients. The number of CD4+ cells increased in the SCDs from the first week to until the end of first month, and then decreased. The number of CD4+ cells decreased from the beginning of the study until the end of first year to 66% of its original value in ECDs. At the first month, the number of CD19+ cells was higher in SCD compared with ECD cases; the number then decreased in both groups. T-regulatory cells had a drop at the first week that lasted until the first month. A bigger increase in SCD and a moderate increase in ECD group were then observed. The kinetics of CD19+ and CD19+ naive cells are similar in the ECD and SCD groups. In the SCD group, cell count decreased in both CD19+ (13%) and CD19+ naive (12%) between third and sixth month. The count of CD19+ cells decreased by 9%, but the count of CD19+ naive cells increased by 11% between the sixth month and first year. The prolonged postoperative uremic state caused by the poorer initial function, together with an aging immune system, explains the weaker immune response in ECD patients, which may be the cause of the decreased number of memory and regulatory T cells. Older patients with an ECD graft need a tailored, personalized, and less aggressive immunosuppressive treatment.

Chlorella vulgaris ameliorates sodium nitrite-induced hepatotoxicity in rats.

The current was conducted to evaluate the ameliorating effect of Chlorella vulgaris (CV) extract against sodium nitrite-induced hepatotoxicity in rats. Forty-five rats were allocated randomly into 5 groups (n = 9). Group I (GI), control group: orally gavaged with normal saline daily. Group II (GII): orally gavaged with CV extract (70 mg/kg BW) for 3 months. Group III (GIII): orally gavaged with sodium nitrite (80 mg/kg BW) for 3 months. Group IV (GIV): received sodium nitrite as GIII and CV extract as GII simultaneously for 3 months. Group V (GV): received CV extract as GII and then, sodium nitrite as in GIII from the end of first month until the end of the experiment. Sodium nitrite significantly increased the activities of serum alanine aminotransferase, aspartate aminotransferase, and serum concentrations of tumor interleukin 1-β and necrosis factor α. In addition, it increased concentrations of malondialdehyde and nitric oxide and expression level of caspase-3 in the hepatic tissue. However, it decreased activities of hepatic glutathione peroxidase, catalase, and superoxide dismutase and induced degenerative and necrotic changes in hepatic tissues. In contrast, CV extract administration modulated sodium nitrite-induced inflammation, oxidative stress, and alteration in hepatic tissue function and architecture. This study indicated that CV extract modulated sodium nitrite-induced hepatic toxicity through decreasing oxidative stress and inflammation and enhancing antioxidant enzyme activities in hepatic tissue of rats.

Echocardiographic Evaluation of the Response to Prazosin Treatment in Scorpion Sting.

Scorpion envenomation is a major public health problem in children that can induce lethal neurological, respiratory and cardiovascular complications. We aimed to evaluate cardiovascular complications with a follow-up of envenomed children for 1 month for possibility of incomplete recovery. This was a prospective study conducted for children who presented with scorpion sting to Emergency and Intensive Care units. Demographic, clinical and laboratory findings of patients were recorded. Cases with suspected clinical and electrocardiographic manifestations of myocarditis were subjected to bedside echocardiography with follow-up at the end of the first week and the first month. Scorpion sting cases presented to our hospital were 81 cases during 1-year study; of them, 17 cases were stable without systemic manifestations after 12 h observation and discharged. Sixty-four cases suffered systemic organic complications and needed ICU admission; their mean age was 11.52 ± 3.74 and 64% of them were males. Twenty-eight of admitted cases showed manifestations of myocarditis and by echocardiography, all of them had evidence of left ventricular dysfunction. On follow-up, there was significant improvement at the end of first week and complete improvement at the end of first month except three cases who died due to pulmonary edema and cardiogenic shock. Acute toxic myocarditis is a common and an important cause of morbidity and mortality following scorpion envenomation that necessitates early and aggressive management. High index of suspicion, serial electrocardiogram monitoring and echocardiography are three integrative lines required to recognize this serious complication. Lay summaryAcute toxic myocarditis is a common cause of morbidity and mortality following scorpion envenomation that necessitates rapid medical treatment. We aimed to evaluate cardiovascular complications after scorpion sting with a follow-up of envenomed children for 1 month for possibility of incomplete recovery. Tachycardia was the most frequent observed cardiac sign followed by hypotension, while the least was bradycardia and hypertension. All cases with manifestations suggestive of myocarditis were evaluated by bedside two-dimensional echocardiography and showed evidence of left ventricular dysfunction, that begin to regress within 1 week of treatment unless progressive pulmonary edema and resistant cardiogenic shock occurred. On follow-up for survivors, complete improvement at the end of first month was noticed. Clinical suspicion, serial ECG monitoring and echocardiography are required for rapid and early diagnosis. Early use of prazosin therapy can prevent long-term residual damage as evidenced by echocardiographic evaluation.

Comparison of Cardiopulmonary Exercise Capacity in Patients with Atrial Septal Defect Treated with Minimally Invasive Cardiac Surgery or Transcatheter Closure

Aim. The main aim of our study was to compare the results of transcatheter atrial septal defect (ASD) closure versus minimally invasive cardiac surgery (MICS) focusing on cardiopulmonary exercise capacity and echocardiographic findings preoperatively and 1 month after defect closure.Material and methods. 54 patients with ASD and finally 43 patients who were followed up were included in the study. 21 patients were in MICS (robotic or endoscopic approach) and 22 patients were in transcatheter closure arm. All patients investigated in detail by transesophageal echocardiography and underwent cardiopulmonary exercise test (CPET). At the end of first month, CPET and transthorasic echocardiography were reperformed.Results. There was significant improvement of physical capacity after 1 month following the transcatheter closure procedure documented by exercise time and VO 2 max. Tricuspid annular plane systolic excursion (TAPSE) and tricuspid lateral annular systolic velocity (Tri S) were not changed. In surgery group right heart diameters declined significantly; but VO 2 max, TAPSE and Tri S significantly decreased.Conclusion. Cardiopulmonary exercise function is increased in transcatheter closure group 1 month after closure and contrary not in MICS group. This may be caused by long recovery time of the right ventricle after surgery. Device closure of ASD is preferable to surgical closure if the anatomy is suitable. However, MICS for ASD closure is safe, with short recovery period and less scarring.

Functional exercises improve quality of life of obese depressed women: a case report study

Background: Depression is characterized by abnormal affective manifestations. This pathology is more frequent among women and is aggravated with the overweight/obesity. Regular exercises have been shown to combat the manifestations of depression, as well as to increase active behavior and improve the morphology. Objectives: This study aimed to evaluate the effect of functional training on morphology, physical activity level and quality of life of obese women with depression. Methods: Four women with mean aged 32.5 ± 10.6 underwent 2 months of functional training, which performed twice a week, each session 1-hour training. Participants were evaluated in 3 times (T): T1) pre-test; T2) at the end of first month (mid-test); and T3) at the end of the second month (post-test). Results: We observed significant changes for the waist circumference variable, and presented a reduction in mid-test and post-test, in relation to the pre-test (p&lt;0.05). No changes were observed for the variables weight and BMI. It was observed a significant increase in the level of physical activity, with the mid-test and post-test in relation to the pre-test (mid-test: p&lt;0.05; post-test: p&lt;0.01). All the indices evaluated by the SF-36 questionnaire showed improvement at mid-test and post-test relative to the pre-test (p&lt;0.05). Conclusions: The present study suggests that engagement in functional training programs provides a significant improvement in aspects related to quality of life and depression, as well as an increase in the level of physical activity, even in the absence of weight reduction.

Rifampicin Resistant Tuberculosis in Lesotho: Diagnosis, Treatment Initiation and Outcomes

The Lesotho guidelines for the management of drug-resistant tuberculosis (TB) recommend initiation of patients diagnosed with rifampicin resistant (RR)-TB on a standardized drug resistant regimen while awaiting confirmation of rifampicin resistant TB (RR-TB) and complete drug susceptibility test results. Review of diagnostic records between 2014 and 2016 identified 518 patients with RR-TB. Only 314 (60.6%) patients could be linked to treatment records at the Lesotho MDR hospital. The median delay in treatment initiation from the availability of Xpert MTB/RIF assay result was 12 days (IQR 7–19). Only 32% (101) of patients had a documented first-line drug resistant test. MDR-TB was detected in 56.4% of patients while 33.7% of patients had rifampicin mono-resistance. Only 7.4% of patients assessed for second-line resistance had a positive result (resistance to fluoroquinolone). Treatment success was 69.8%, death rate was 28.8%, loss to follow up was 1.0%, and 0.4% failed treatment. Death was associated with positive or unavailable sputum smear at the end of first month of treatment (Fisher exact p < 0.001) and older age (p = 0.007). Urgent attention needs to be given to link patients with RR-TB to care worldwide. The association of death rate with positive sputum smear at the end of the first month of treatment should trigger early individualization of treatment.

P1256 Salvage mitraclip implantation for postmyocardial infarction mitral regurgitation: 2 case reports

Abstract Introduction Acute mitral regurgitation (MR) secondary to AMI is associated with a poor clinical outcome. The role of MitraClip implantation (MCI) in this population is still not well established. We report two successful cases of salvage MCI in acute ischaemic MR. Case Report 1: A 66-year-old diabetic woman was admitted to our institution due to extensive anterior STEMI with cardiogenic shock. Urgent cardiac catheterization (CC) revealed 100% occlusion of the left anterior descending and critical stenosis of the obtuse marginal artery, with successful PCI of both vessels and implantation of an intra-aortic balloon pump. Early transthoracic echocardiogram (TTE) revealed a dilated left ventricle with severe systolic dysfunction (LVEF – 35%), apical and anterior wall akinesia and functional grade IV MR (EROA - 40mm2 and regurgitant volume - 45mL), that was later confirmed by transesophageal echocardiography (TEE). 48h after AMI, the patient developed an arrhythmic storm requiring multiple shocks and a prolonged period of mechanical ventilation. Due to an extremely slow clinical improvement, with the need for prolonged inotropic support and refractory pulmonary congestion (NYHA IV), she was submitted to MCI, resulting in post-procedural grade I MR (EROA 7mm2 and regurgitant volume 11mL) and a marked clinical and hemodynamic improvement. An ICD for secondary prevention was implanted. At the 3 month follow-up the patient presented in NYHA II functional class without congestive symptoms. Case Report 2: An 82-year old female patient was admitted with an inferior STEMI, with CC documenting severe 3 vessel disease with a calcified occlusion of the right coronary artery, not amenable to PCI, so the patient was submitted to emergent CABG. There was a prolonged period of post-operatory mechanical ventilation with an extremely difficult weaning process, including the need for re-intubation due to acute pulmonary edema. TTE revealed LVEF of 39% with a large inferobasal aneurysm and severe eccentric MR due to tendinous cord rupture. The patient was submitted to MCI with immediate significant improvement of the MR, allowing successful extubation 36 hours after the procedure. In the end of first month of follow-up, the TTE revealed a well-positioned clip with mild-to-moderate MR (EROA – 21.5mm2 and regurgitant volume – 38mL) with the patient being completely asymptomatic. Conclusion Treatment of acute MR following AMI with MCI may be a safe and effective approach in critically ill patients. In our experience, it can lead to a rapid clinical recovery and resolution of cardiogenic shock.

A Placebo‐Controlled Study on the Treatment of Metabolic Syndrome of Qi Stagnation and Dampness Obstruction Related to Atypical Antipsychotics with Traditional Chinese Medicine (TCM)

Methods 154 schizophrenics who met both the diagnostic criteria of metabolic syndrome and qi stagnation and dampness obstruction syndrome were randomly divided into 2 : 1 groups. The PANSS and Tess were assessed before treatment and at the end of first month, second month, and third month after treatment; blood pressure, weight, waist circumference, hip circumference, blood glucose, glycosylated hemoglobin, high-density lipoprotein, low-density lipoprotein, triglyceride, and cholesterol were also measured at the same four time points. On the basis of continuous antipsychotic treatment, the study group took Liuyu decoction, and the control group took placebo. Results Of the 154 cases, 102 were in the study group and 52 in the control group. Before and after treatment, there was a slight increase but no significant difference in blood pressure, blood sugar, glycosylated hemoglobin, cholesterol, TG, DHL, and LHL in two groups (P > 0.05) and also between the two groups (P > 0.05). The body weight, waist circumference, hip circumference, and BMI in the study group decreased, while that in the control group increased from the dividing group to the end of study. At the end of the third month, there was a significant difference in the body weight, waist circumference, hip circumference, and BMI between the two groups (P < 0.05). Before and after treatment, there was a significant difference in positive symptoms, negative symptoms, general symptoms, and PANSS in two groups, respectively (P < 0.05). The negative symptoms, general symptoms, PANSS, and TESS in the study group were lighter than that in the control group after treatment. Conclusion Liuyu decoction is not only beneficial to the treatment in body constitution of metabolic syndrome in qi stagnation and dampness obstruction but also beneficial to the improvement of such patients' mental symptoms and side effects.

CN77 - Effect of Kegel exercises on prevention of urinary and fecal incontinence in patients with prostate cancer undergoing radiotherapy

BackgroundProstate cancer (PC) is the second most common type of cancer among men. During radiotherapy (RT), some of the healthy tissues can be irradiated and side effects such as urinary (UI) and fecal incontinence (FI) may occur. MethodsThis non-randomized study was conducted to determine the effect of Kegel exercises on prevention of UI and FI in PC patients undergoing RT at the Gazi Hospital in the dates of 10.12.2016-03.01.2018. 60 patients were included in the study, 30 in the experimental and 30 in the control group. Data was collected with information form, CTCAE, EORTC QLQ-C30, REALM, weekly exercise follow-up schedule. The experimental group was provided individual training on Kegel exercises, training booklet was given, and patients were followed up weekly. Data collection forms were repeated before training, at the end of the first month and second month. No similar intervention was provided for the control group. Chi-square, Mann-Whitney U, Kruskal-Wallis, Friedman, Wilcoxon tests, variance analysis were used for the data analysis. ResultsExperimental and control groups were found to have been distributed homogeneously. At the end of first month, 10% of the experimental group and 13.3% of the control group had first grade UI. At the end of second month, only 1% of the control group had first grade UI, 3.3% of the experimental group and 6,7% of the control group had second grade UI. Besides, FI was not developed in both groups. It was found that social function of the EORTC QLQ-C30 increased in the experimental group. Additionally, diarrhea, insomnia, loss of appetite in the symptom sub-scale decreased in the same group. Improvement was observed in the overall health condition of the experimental group, whereas the control group was observed to be worse (p<0,05). ConclusionsAlthough Kegel exercises were not found effective, UI rate was lower in the experimental group. It has been recommended that Kegel exercises should be performed in larger groups with long-term observations. Legal entity responsible for the studyAydan Eda Urvaylıoğlu, Sevinç Kutlutürkan, Diclehan Kılıç. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

A study on the efficacy and adverse effects of methotrexate in psoriasis patients in a tertiary care centre

Background: Psoriasis is a common, chronic and recurrent inflammatory disease of the skin. Methotrexate has been used in patient with psoriasis, a folic acid antagonist interfering with purine pathway and the mechanism of action in psoriasis is immune modulation and anti-inflammation. So, this study aims at monitoring the efficacy and adverse effects of methotrexate in south Indian patients with psoriasis attending a tertiary care hospital.Methods: It is a prospective, observational study conducted for a period of one year in subjects of either sex having psoriasis. Methotrexate was initiated in a single weekly oral dose of 5mg to 25mg. The efficacy was evaluated using psoriasis Area and Severity Index (PASI) score in all patients before starting methotrexate therapy and the end of first month, third month and sixth month of therapy. Adverse reaction was monitored.Results: All 40 psoriasis patients after treatment with methotrexate therapy showed improved skin lesions by falling PASI scoring at the end of first, third and sixth month of treatment. None of the patients in our study had pulmonary toxicity, life threatening adverse effects which required hospitalization.Conclusions: Use of methotrexate in the treatment of psoriasis in this study was found to be safe and highly efficacious and caused minimal adverse effects and it was well tolerated.

Chemometric properties of wines treated with natural extracts as an alternative of sulphur dioxide

Sulphur dioxide (SO2) is commonly used as an antioxidant and antimicrobial compound during wine production. Phenols naturally existence in plant extracts have been reported to possess antioxidative, antimicrobial activities, and as anti-inflammatory activities. Since few consumers preferred foods treated with natural preservatives, the aim of this study was to determine the effects of different natural plant extracts as an alternative of sulphur dioxide used in wines. Wine production was done according to the accepted conventional method for red wines (Cabernet sauvignon). The experimental design was achieved by using different plant extracts (grape pomace, rosemary, black blueberry) at different concentrations. As controls were used wine samples produced without natural extracts and second group samples produced without addition of sulphur dioxide (SO2). At the end of production basic analyzes (total acidity, volatile acidity, pH, dry matter, ash, free and total SO2), and colorimetric wine analyses (TWP, WC, CD, CI, %R, %Y, %B, Abs280, Abs420, Abs520, Abs620, %dA and tint values) were performed. Analyses on n-dimensional scale demonstrated that each used plant exact have different effects on required SO2and wine quality parameters. The lowest concentrations of grape pomace extract caused reduction of SO2and maintaining the required wine properties. The highest value of the end of first month of storage for TWP, WC, Abs280, Abs520, %R values were determined for grape pomace treatment wines. The highest value of the TPW were determined for samples treated with grape pomace (1 ml/L extract), rosemary (1 ml/L extract), and blue berry (1 ml/L extract with 25 mg/L SO2) 2.710, 2.550 and 2.520 respectively. Results emphasized the importance of used plant extracts and their concentrations. The study demonstrated the possibilities of SO2optimization on the base of used natural plant extracts.