Incidence Of Adverse Reactions Research Articles

The impact of hemovigilance studies on transfusion practices: Single centre experience

Objective: Blood product transfusion is one of the most commonly used medical interventions worldwide. However, transfusion-related adverse events (TRAEs) can cause morbidity and rarely even mortality in patients. For this reason, hemovigilance studies have recently gained importance in terms of safe and effective implementation of transfusion. Material and methods: Transfusion practices issued in the period of 2016-2023 were analyzed retrospectively. All TRAE including adverse reactions (AR) and adverse events (AE) were recorded. The impact of hemovigilance practices on the incidence of TRAE was analyzed by comparing the numbers and types of events between years. Results: 135506 blood products were used for a total of 45571 patients for a total of 8 years between 2016 and 2023. 172 adverse reactions (AR) were reported in 170 patients. The overall AR incidence was found to be 126.8 (/100000). The highest yearly AR rate was reported in 2018 with 168.04 (/100000). Since hemovigilance measures were tightened, a statistically significant decrease was recorded in ARs from the beginning of 2020 to date (p

Clinical Efficacy of Dienogest Combined with Wenjing Tang in Adenomyosis

Objective: To investigate the clinical efficacy of Dienogest (DNG) combined with Wenjing Tang Formula in patients with uterine adenomyosis. Methods: 60 patients with adenomyosis were randomly divided into Group A and Group B. Group A patients received continuous oral treatment with DNG 2 mg/d for 3 months, while Group B patients were given Wenjing Tang Formula based on Group A treatment. The treatment effect, size of adenomyoma and incidence of adverse reactions were compared between the two groups. Results: The total effective rate of treatment in Group B was 96.67%, which was significantly higher than 73.33% in Group A (P < 0.05); the size of uterine adenomyoma in Group B was significantly smaller than that in Group A, with a significant difference (P < 0.05). In terms of the incidence of adverse reactions, group B was 6.67%, which was significantly lower than 26.67% in group A (P < 0.05). Conclusion: The treatment of adenomyosis of the uterus via dienogest combined with the addition and subtraction of Wenjing Tang showed higher therapeutic efficacy and significant tumor shrinkage, and at the same time, it could reduce the incidence of adverse reactions, which has a good prospect of clinical application, and it is recommended to be promoted for use in clinical practice.

Comparative observation between Roxithromycin and Azithromycin sequential therapy in the treatment of Mycoplasma pneumoniae Pneumonia in Children

Objective: To investigate the clinical efficacy of roxithromycin combined with azithromycin sequential therapy in the treatment of mycoplasma pneumoniae pneumonia in children. Methods: A retrospective study was conducted on 100 patients with mycoplasma pneumoniae pneumonia admitted to The First Affiliated Hospital of Yangtze University from January 2020 to December 2022. All patients were divided into the observation group (roxithromycin combined with azithromycin sequential therapy) and the control group (azithromycin sequential therapy), with 50 cases in each group. The clinical efficacy, improvement time of clinical symptoms/signs, inflammation indexes, oxidative stress indexes and immune function levels of the two groups were compared. Moreover, the improvement of lung function indexes and the adverse reactions were observed. Results: The overall response rate of the observation group was 96.00%, which was higher than the control group (84.00%) (p<0.05). The time of clinical symptoms/signs in the observation group were significantly lower than those in the control group(p<0.05). After treatment, significant improvements were seen in the levels of CRP, TNF-α, IL-6, GSH-Px, SOD, MDA, CD3+, CD4+, CD4+/CD8+, IgM, IgG , IgA, FEV1, FEV1%, FVC and FEV1/FVC of the two groups compared with those before treatment (p<0.05), and the improvement in the observation group was more obvious than that in the control group (p<0.05). The overall incidence of adverse reactions in the observation group was 6.00%, which was slightly lower than that in the control group (8.00%) (c²=0.154, P=0.695). Conclusion: Roxithromycin combined with azithromycin sequential therapy is a safe regimen for the treatment of mycoplasma pneumoniae pneumonia in children. doi: https://doi.org/10.12669/pjms.40.9.8942 How to cite this: Liu D, Zhang Y. Comparative observation between Roxithromycin and Azithromycin sequential therapy in the treatment of Mycoplasma pneumoniae Pneumonia in Children. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.8942 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Incidence, characteristics, and risk factors of hypofibrinogenemia induced by generic tigecycline: a retrospective study.

The objective of this study was to evaluate the incidence, clinical features, and risk factors of generic tigecycline-associated hypofibrinogenemia. A single-center retrospective study was conducted in adult patients treated with generic tigecycline. Clinical data were extracted from the electronic medical records. The endpoint was tigecycline-related hypofibrinogenemia, defined as a condition with no abnormality in fibrinogen before tigecycline application, but developing hypofibrinogenemia upon prescription. The risk factors were determined by logistic regression analysis, and the ROC curve was subsequently established. A total of 240 adults prescribed generic tigecycline from May 1st to November 30th 2023 were included. It was shown that hypofibrinogenemia is a frequent side effect of generic tigecycline, with an adverse reaction rate of 42.9% (103/240). However, the incidence of adverse reactions to generic drugs was lower than in previous studies. The cumulative dose of tigecycline (OR:1.002, 95%CI 1.001-1.002, P < 0.001), baseline FIB (OR:0.995, 95%CI 0.992-0.997, P < 0.001), baseline PT (OR:1.247, 95%CI 1.071-1.452, P = 0.004) and baseline ALB (OR:0.931, 95%CI 0.879-0.986, P = 0.025) were identified as independent prognostic factors of tigecycline-related hypofibrinogenemia. We recommend intensive monitoring of coagulation function in patients exhibiting the aforementioned risk factors for generic tigecycline-associated hypofibrinogenemia to ensure patients safety.

Chemotherapy combined with Shenmai injection alleviates inflammatory response and side effects in the patients with advanced colorectal cancer: A retrospective analysis

Objective: To assess the inflammatory response and side effects of chemotherapy combined with Shenmai injection (SMI) in the treatment of patients with advanced colorectal cancer (CRC). Methods: This retrospective cohort study included the clinical data of 152 patients with advanced CRC admitted to the First Affiliated Hospital of Huzhou University from April 2020 to April 2023. The patients were divided into control group (patients received chemotherapy treatment, n=75) and observation group (patients received chemotherapy combined with SMI, n=77) based on the treatment received. Tumor control rate, levels of immune function indicators before and after treatment, levels of inflammatory factor indicators, and incidence of toxic side effects in two groups were analyzed. Results: Tumor control rate in the observation group (89.61%) was higher than that in the control group (77.33%) (P&lt;0.05). After the treatment, the levels of CD3+, CD4+, CD4+/CD8+in both groups were significantly higher than before the treatment, and significantly higher in the observation group compared to the control group (P&lt;0.05). After the treatment, serum levels of interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-8 (IL-8) in both groups decreased compared to pretreatment levels, and was significantly lower in the observation group (P&lt;0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P&lt;0.05). Conclusions: Compared with chemotherapy alone, chemotherapy combined with SMI better alleviates inflammatory response in patients with advanced CRC, enhance immune function, and improve tumor control rate, with a lower incidence of toxic side effects. doi: https://doi.org/10.12669/pjms.40.9.9881 How to cite this: Jin Y, Zhu W, Dai H, He X. Chemotherapy combined with Shenmai injection alleviates inflammatory response and side effects in the patients with advanced colorectal cancer: A retrospective analysis. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.9881 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Clinical efficacy and safety of targeted therapy, immunotherapy combined with chemotherapy for treating patients with advanced gastric cancer

Objective: Exploring the clinical efficacy and safety of targeted therapy, immunotherapy combined with chemotherapy in the treatment of advanced gastric cancer. Methods: A retrospective analysis was performed on the medical records of 134 patients with advanced gastric cancer who visited Renmin Hospital, Hubei University of Medicine from January 2019 to December 2022. According to therapeutic regimens, enrolled patients were divided into the control group and the study group. Patients in the control group received chemotherapy intervention, while those in the study group were provided with a combined intervention of apatinib, PD-1 inhibitor and chemotherapy. We analyze the tumor control effect and incidence of adverse reactions in two groups of patients. Results: The disease control rate (DCR) of patients in the study group and the control group was 72.06% and 42.42%, with an overall response rate (ORR) of 8.82% and 4.55%, The differences are statistically significant(P&lt;0.05). By the end of follow-up, the median progression-free survival (mPFS) and the median overall survival (mOS) of the control group patients were 3.0±0.266 and 5.0±0.224 months respectively; while the mPFS and mOS of the study group were 5.0±0.261 and 7.0±0.172 months respectively, the differences are statistically significant (P&lt;0.05). However, there was no significant difference in adverse reactions between the two groups (P&gt;0.05). Conclusion: The therapeutic regimen of apatinib, a PD-1 inhibitor combined with chemotherapy exhibits relatively high clinical efficacy and safety for the treatment of patients with advanced gastric cancer. It can be considered as an interventional option for this type of patient. doi: https://doi.org/10.12669/pjms.40.9.9049 How to cite this: Yang D, Gao Z, Yang X, Gao L. Clinical efficacy and safety of targeted therapy, immunotherapy combined with chemotherapy for treating patients with advanced gastric cancer. Pak J Med Sci. 2024;40(9):---------. doi: https://doi.org/10.12669/pjms.40.9.9049 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

An investigation into the correlation between intraperitoneal teicoplanin concentrations and treatment outcomes in peritoneal dialysis-associated peritonitis.

Peritoneal dialysis-associated peritonitis (PDAP) is a frequent complication of peritoneal dialysis. The guidelines from the International Society for Peritoneal Dialysis (ISPD) suggest administering teicoplanin through the peritoneal route to treat PDAP, but do not specify the ideal concentration for peritoneal dialysis effluent (PDE). Patients meeting the trial criteria for PDAP in our hospital between July 2022 and December 2023 were enrolled. Data on PDE white blood cell count, PDE neutrophil percentage, clinical symptoms, CRP, and PCT were gathered pre- and post-treatment. Incidences of adverse drug reaction (ADR) and case numbers during treatment were recorded. Subsequently, patients were categorized into cured and uncured groups for evaluating the relationship between PDE teicoplanin concentration and treatment effectiveness. The self-control study results on teicoplanin efficacy indicated intraperitoneal teicoplanin administration achieved an efficacy rate of 88.9% and an ADR incidence of 5.5% in treating PDAP patients. There was no observed correlation between teicoplanin blood concentration and PDE concentration. PDE teicoplanin concentrations on days 1, 3, 5, and 7 post-dosing were higher inthe cured group, with a significant contrast in PDE concentration on day 5 between the 18.98 ± 2.43mg/L of the cured group and the 12.07 ± 2.68mg/L of the uncured group. ROC curve revealed a higher likelihood of cure in patients when PDE teicoplanin concentration exceeded 15.138mg/L on day 5 post-dosing. Univariate and multifactorial studies identified 24-h urine volume and the number of daily abdominal dialysis sessions as influential factors in PDE teicoplanin concentration on day 5. A positive correlation was found between 24-h urine volume and PDE teicoplanin concentration, with PDAP patients having urine volume over 537mL showing significantly higher drug concentrations. Conversely, the number of daily PDAP sessions was negatively correlated with PDE teicoplanin concentrations, indicating that patients with 1∼3 daily PDAP sessions had notably higher PDE teicoplanin concentrations compared to those with 4∼6 sessions. Therefore, PDAP patients who use intraperitoneal teicoplanin could effectively control infection by monitoring the PDE teicoplanin concentration (>15.138mg/L) on day 5 after dosing.

Effect of acupuncture anesthesia on inflammatory response and cellular immunity in patients with osteoporotic fractures.

Osteoporotic vertebral compression fractures (OVCFs) occur frequently in the elderly, with percutaneous vertebroplasty (PVP) being the major clinical treatment at present. How to improve the patient's surgical cooperation while ensuring surgical safety is the focus of clinical research. This study explores the influence of acupuncture anesthesia (AA) on the safety, inflammatory response, and cellular immunity of OVCF patients undergoing PVP, which may provide a more reliable safety guarantee for future treatment of OVCFs. The results showed that patients using AA had lower postoperative Visual Analogue Scale (VAS) scores and incidence of postoperative adverse reactions, a smaller anesthetic dosage, but an extended duration of anesthesia; moreover, the postoperative inflammatory response was markedly alleviated and the stability of T lymphocyte subsets was obviously enhanced. Therefore, AA has high clinical application value in PKP treatment of OVCFs in the future.

Comparison of postoperative analgesia by thoracoscopic-guided thoracic paravertebral block and thoracoscopic-guided intercostal nerve block in uniportal video-asssited thoracic surgery: a prospective randomized controlled trial

BackgroundThoracoscopic-guided thoracic paravertebral nerve block (TG-TPVB) and thoracoscopic-guided intercostal nerve block (TG-INB) are two postoperative analgesia technology for thoracic surgery. This study aims to compared the analgesic effect of TG-TPVB and TG-INB after uniportal video-asssited thoracic surgery (UniVATS).MethodsFifty-eight patients were randomly allocated to the TG-TPVB group and the TG-INB group. The surgical time of nerve block, the visual analog scale (VAS) scores, the consumption of sufentanil and the number of patient-controlled intravenous analgesic (PCIA) presses within 24 h after surgery, the incidence of adverse reactions were compared between the two groups.ResultsThe VAS scores were significantly lower during rest and coughing at 2, 6, 12, and 24 h in the TG-TPVB group than in the TG-INB group (P < 0.05). The consumption of sufentanil and the number of PCIA presses within 24 h after surgery were significantly lower in the TG-TPVB group than in the TG-INB group (P < 0.001).The surgical time of nerve block was significantly shorter in the TG-TPVB group than in the TG-INB group (P < 0.001). The incidence of bleeding at the puncture point was lower in the TG-TPVB group than that in the TG-INB group (P < 0.05).ConclusionTG-TPVB demonstrated superior acute pain relieve after uniVATS, shorter surgical time and non-inferior adverse effects than TG-INB.

Effect of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia

BackgroundTo analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clinical application.MethodsA total of 111 patients with gastric cancer who were treated with epidural anesthesia combined with general anesthesia were selected as the study subjects, and the patients were randomly divided into group A, group B and group C. The bispectral index (BIS) was maintained by adjusting the infusion speed of anesthetics, the BIS of group A was maintained at 50 ~ 59, the BIS of group B was maintained at 40 ~ 49, and the BIS of group C was maintained at 30 ~ 39. The high-frequency power (HFP), low-frequency power (LFP), total power (TP), mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) were measured before anesthesia induction (T1), immediately after intubation (T2), 3 min after intubation (T3), and 6 min after extubation (T4). The cognitive function of the patients was evaluated before and 48 h after surgery.ResultsThe HFP, LFP/HFP, TP, HR, DBP and SBP between the three groups at T1 ~ T3 are significantly difference from each other (P < 0.05). There were significant differences in spontaneous breathing recovery time, eye opening time and extubation time among group A, B and C groups, and group B had the lowest spontaneous breathing recovery time, eye opening time and extubation time (P < 0.05). There was no significant difference in the incidence of adverse reactions during anesthesia between the three groups. The cognitive function score of group B was significantly higher than that of group A and group C (P < 0.05).ConclusionsBIS maintenance of 40 ~ 49 has little effect on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, which is helpful for postoperative recovery.

Index of Consciousness monitoring may effectively predict and prevent circulatory stress induced by endotracheal intubation under general anesthesia: a prospective randomized controlled trial

BackgroundThe primary objective of anesthesiologists during the induction of anaesthesia is to mitigate the operative stress response resulting from endotracheal intubation. In this prospective, randomized controlled trial, our aim was to assess the feasibility and efficacy of employing Index of Consciousness (IoC, IoC1 and IoC2) monitoring in predicting and mitigating circulatory stress induced by endotracheal intubation for laparoscopic cholecystectomy patients under general anesthesia (GA).MethodsWe enrolled one hundred and twenty patients scheduled for laparoscopic cholecystectomy under GA and randomly allocated them to two groups: IoC monitoring guidance (Group T, n = 60) and bispectral index (BIS) monitoring guidance (Group C, n = 60). The primary endpoints included the heart rate (HR) and mean arterial pressure (MAP) of the patients, as well as the rate of change (ROC) at specific time points during the endotracheal intubation period. Secondary outcomes encompassed the systemic vascular resistance index (SVRI), cardiac output index (CI), stroke volume index (SVI), ROC at specific time points, the incidence of adverse events (AEs), and the induction dosage of remifentanil and propofol during the endotracheal intubation period in both groups.ResultsThe mean (SD) HR at 1 min after intubation under IoC monitoring guidance was significantly lower than that under BIS monitoring guidance (76 (16) beats/min vs. 82 (16) beats/min, P = 0.049, respectively). Similarly, the mean (SD) MAP at 1 min after intubation under IoC monitoring guidance was lower than that under BIS monitoring guidance (90 (20) mmHg vs. 98 (19) mmHg, P = 0.031, respectively). At each time point from 1 to 5 min after intubation, the number of cases with HR ROC of less than 10% in Group T was significantly higher than in Group C (P < 0.05). Furthermore, between 1 and 3 min and at 5 min post-intubation, the number of cases with HR ROC between 20 to 30% or 40% in Group T was significantly lower than that in Group C (P < 0.05). At 1 min post-intubation, the number of cases with MAP ROC of less than 10% in Group T was significantly higher than that in Group C (P < 0.05), and the number of cases with MAP ROC between 10 to 20% in Group T was significantly lower than that in Group C (P < 0.01). Patients in Group T exhibited superior hemodynamic stability during the peri-endotracheal intubation period compared to those in Group C. There were no significant differences in the frequencies of AEs between the two groups (P > 0.05).ConclusionThis promising monitoring technique has the potential to predict the circulatory stress response, thereby reducing the incidence of adverse reactions during the peri-endotracheal intubation period. This technology holds promise for optimizing anesthesia management.Trail registration Chinese Clinical Trail Registry Identifier: ChiCTR2300070237 (20/04/2022).

Effectiveness of Remimazolam Benzenesulfonate Combined with Alfentanil in Elderly Patients Undergoing Painless Gastroenteroscopy

Objective: To observe the effects of remimazolam benzenesulfonate combined with alfentanil during painless gastroenteroscopy in elderly patients. Methods: This study analyzes patients aged 60–85 years old undergoing painless gastroenteroscopy. A total of 140 patients, examined between February 2023 and February 2024, voluntarily participated and were randomly divided into an experimental group and a control group. The control group received alfentanil combined with propofol for anesthesia, while the experimental group received alfentanil combined with remimazolam benzenesulfonate. The relevant indices of both groups were separately analyzed. Results: Patients in the experimental group had a shorter awakening time, a faster discharge rate (P &lt; 0.05), and a shorter examination duration; however, the difference in examination time between the two groups was not statistically significant (P &gt; 0.05). Before anesthesia, there was no significant difference in the basic information and vital signs of the two groups (P &gt; 0.05). Two minutes after anesthesia, both groups showed a decline in vital signs, but the vital signs of the experimental group remained more stable after the procedure, with the group’s indices showing improvement over the control group (P &lt; 0.05). Additionally, the incidence of adverse reactions in the experimental group was lower than in the control group (P &lt; 0.05). Conclusion: In painless gastroenteroscopy for elderly patients, anesthesia using a combination of remimazolam benzenesulfonate and alfentanil improves anesthesia effectiveness, hastens patient recovery, enhances the stability of vital signs, and effectively controls adverse reactions, thereby improving patient comfort.

Assess Incidence and Presentation of Cutaneous Adverse Drug Reactions in Patients Presenting at Jeddah's Tertiary Care Facilities

Background: It is often necessary to differentiate cutaneous signs of adverse medication reactions from other similar appearances. Because patients frequently fail to recognize the connection between drug consumption and ensuing cutaneous manifestations, early detection of these responses is imperative. Purpose: Investigating the prevalence of Cutaneous Adverse Drug Reactions (CADRs) at a teaching hospital for tertiary care is the goal of this study. Methods: A self-reporting technique was used to select cases in a prospective, observational trial that lasted six months in Saudi German hospital in Jeddah . The following categories applied to Cutaneous Adverse Drug Reactions: definite, potential, and probable. Results: The most common cutaneous manifestation of ADRs (42.85%) was maculopapular rash, which was linked to antimicrobials (48.30%) and nonsteroidal anti-inflammatory drugs (21.90%) during the study period, which resulted in 91 cases of Cutaneous Adverse Drug Reactions. Conclusion: Since cutaneous adverse drug reactions are common, raising awareness of them is crucial to diagnosing and preventing them.

Efficacy and Safety of Different Preemptive Analgesia Measures in Pain Management after Laparoscopic Cholecystectomy: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

The purpose of this systematic review and network meta-analysis was to evaluate the efficacy and safety of different preemptive analgesia measures given before laparoscopic cholecystectomy (LC) for postoperative pain in patients. We conducted a comprehensive search in databases including PubMed, Web of Science, Embase, and the Cochrane Library up to March 2024, and collected relevant research data on the 26 preemptive analgesia measures defined in this article in LC surgery. Outcomes included postoperative Visual Analogue Scores (VAS) at different times (2, 6, 12, and 24h), opioid consumption within 24h post-operation, time to first rescue analgesia, incidence of postoperative nausea and vomiting (PONV), and incidence of postoperative headache or dizziness. Forty-nine articles involving 5987 patients were included. The network meta-analysis revealed that multimodal analgesia, nerve blocks, pregabalin, and gabapentin significantly reduced postoperative pain scores at all postoperative time points and postoperative opioid consumption compared to placebo. Tramadol, pregabalin, and gabapentin significantly extended the time to first rescue analgesia. Ibuprofen was the best intervention for reducing PONV incidence. Tramadol significantly reduced the incidence of postoperative headache or dizziness. Subgroup analysis of different doses of pregabalin and gabapentin showed that compared to placebo, pregabalin (300mg, 150mg) and gabapentin (600mg, 300mg, and 20mg/kg) were all more effective without significant differences in efficacy between these doses. Higher doses increased the incidence of PONV and postoperative headache and dizziness, with gabapentin 300mg having a lower adverse drug reaction (ADR) incidence. Preemptive analgesia significantly reduced postoperative pain intensity, opioid consumption, extended the time to first rescue analgesia, and decreased the incidence of PONV and postoperative headache and dizziness. Multimodal analgesia, nerve blocks, pregabalin, and gabapentin all showed good efficacy. Gabapentin 300mg given preoperatively significantly reduced postoperative pain and ADR incidence, recommended for preemptive analgesia in LC. PROSPERO CRD42024522185.

Long-term Efficacy and Safety of Sodium Oxybate in Treating Alcohol Use Disorder: A Systematic Review and Meta-Analysis.

Worldwide, three million deaths each year are reported due to the harmful use of alcohol. To date, only a few drugs have been approved for the treatment of Alcohol Use Disorder (AUD). This systematic review and meta-analysis aim to assess the long-term efficacy and safety of sodium oxybate (SMO) treatment in patients with AUD. We followed the PRISMA statement guidelines and searched PubMed and ISI Web of Science to retrieve the studies of interest. In total, 13 studies on long-term (>12 weeks) SMO administra- tion in patients with AUD were included in this systematic review, and 7 were included in the meta- analysis. Overall, the abstinence rate after 12 weeks of treatment was similar in the SMO and placebo groups, while it was significantly in favour of SMO compared to Naltrexone (NTX). The completion rate was similar in all three conditions. Mean corpuscular volume (MCV) levels favoured SMO over NTX, while Alcohol Craving Scale (ACS) scores did not favour SMO. The incidence of adverse reactions varied widely between studies. SMO in the chronic treatment of patients with AUD showed no superiority to placebo in our analysis of published RCTs, although many observational studies reported its beneficial effect in the long term. On the contrary, SMO was superior to NTX treatment on abstinence. The rate of study completion was similar in the three groups. Safety was not an issue in any of the studies included. Further studies are needed to better assess SMO efficacy and safety in the long term.</p>.

Comparison of the effects of losartan potassium and benazepril in the treatment of hypertensive patients with insulin resistance.

To compare the efficacy of losartan potassium (LP) and benazepril in the treatment of hypertensive patients with insulin resistance (IR). This is a retrospective analysis of the clinical data of 155 hypertensive patients with IR admitted to Shanghai Pudong New Area People's Hospital from March 2021 to March 2023. Of these 76 received LP treatment (LP group), and 79 received benazepril treatment (benazepril group). Blood pressure levels, blood glucose and insulin levels, treatment efficacy, and incidence of adverse reactions before and after the treatment in both groups were compared. After the treatment, diastolic and systolic blood pressure in the two groups significantly decreased compared to pre-treatment levels (P<0.05), with no significant difference between the two groups (P>0.05). After the treatment, levels of fasting plasma glucose (FPG), 2-hours plasma glucose (2hPG), fasting insulin (FINS), 2-hours insulin (2hINS), and insulin sensitivity index (ISI) in both groups significantly decreased compared to pre-treatment levels (P<0.05), with no significant difference between the two groups (P>0.05). There was no significant difference in the total efficacy and the incidence of adverse reactions between the two groups (P>0.05). The efficacy of LP and benazepril in treating hypertension with IR is equivalent. Both are safe and can effectively lower blood sugar and insulin levels, alleviate IR, and lower blood pressure.

Effect of probiotics combined with Ulinastatin and Somatostatin in the treatment of severe acute pancreatitis.

To evaluate the clinical effect of probiotics combined with Ulinastatin and Somatostatin in the treatment of severe acute pancreatitis. A retrospective study was conducted on 160 patients with severe acute pancreatitis treated in the First Affiliated Hospital of Bengbu Medical College from July 2021 to June 2023. There were 78 patients received Ulinastatin and Somatostatin treatment (Control group), and 82 patients received probiotics in addition to Ulinastatin and Somatostatin treatment (Observation group). The treatment effect and the time required to alleviate clinical symptoms were compared between the two groups. Serum levels of inflammatory factors, intestinal mucosal indexes and the incidence of adverse reactions before and after treatment were analyzed. The total efficacy of the Observation group (95.12%) was higher than that of the Control group (85.90%) (P<0.05). Combined probiotic/Ulinastatin + Somatostatin treatment was associated with shorter time to remission of the clinical symptoms (P<0.05). After the treatment, serum levels of inflammatory factors in the two groups were decreased, and was significantly lower in the Observation group compared to the Control group (P<0.05). Similarly, post-treatment serum levels of intestinal mucosal indexes in the two groups were lower than before the treatment, and significantly lower in the Observation group (P<0.05). There was no significant difference in the incidence of adverse reactions between the groups (P>0.05). A combined regimen of probiotics, Ulinastatin and Somatostatin is safe and can more effectively relieve clinical symptoms in patients with severe acute pancreatitis, reduce levels of inflammatory factors, lower intestinal mucosal damage and improve the overall treatment effect compared to Ulinastatin and Somatostatin regimen alone.

Effect of a subanesthetic dose of esketamine combined with propofol on postoperative fatigue syndrome in patients undergoing gastroenterological endoscopy under anaesthesia: A retrospective study.

To assess the effect of subanesthetic dose of esketamine in combination with propofol on the incidence of postoperative fatigue syndrome (POFS) in patients who underwent gastroenterological endoscopy under anaesthesia. Clinical data of 160 patients who underwent gastroenterological endoscopy under anaesthesia in Huzhou Maternity & Child Health Care Hospital from January to December 2022, ASA Grade- I and II, were retrospectively selected. According to the records, patients were grouped based on the administered anesthetic. Patients who received 0.2 mg/kg of esketamine and 2~2.5mg/kg of propofol comprised Group-E, and patients who were administered one μg/kg of fentanyl and 2 - 2.5mg/kg of propofol comprised Group-F. Mean arterial pressure (MAP), oxygen saturation (SpO2) and heart rate (HR) were recorded before the operation (T0), after anesthesia (T1), three minutes after the gastroscope was inserted (T2), five minutes after the colonoscope was inserted (T3) and at the end of the operation (T4). Operating time, recovery time, propofol dosage and incidence of adverse reactions in the two groups were recorded. The Christensen scores and the incidence of POFS of all patients on Day-I before operation and 1st, 3rd, and 5th days after the operation were recorded. Compared with T0, MAP, SpO2 and HR in both groups of patients decreased at T1, T2, T3 and T4 (P<0.05). MAP, SpO2 and HR of patients in Group-E were significantly higher compared to Group-F at T1, T2, T3 and T4 (P<0.05). Compared with Group-F, the recovery time, intraoperative bradycardia and respiratory depression in Group-E were significantly lower (P<0.05), and Christensen scores and the incidence of POFS decreased significantly on the 1st, 3rd, and 5th day after the operation (P<0.05). Subanesthetic dose of esketamine combined with propofol can reduce POFS and postoperative adverse reactions in patients undergoing gastroenterological endoscopy.

Efficacy and safety of methotrexate plus hydroxychloroquine combination therapy vs. methotrexate monotherapy in the treatment of rheumatoid arthritis: A randomized controlled clinical trial.

To explore the efficacy and safety of combination therapy with methotrexate (MTX) plus hydroxychloroquine (HCQ) vs. MTX monotherapy in patients with rheumatoid arthritis (RA). Sixty patients without prior RA treatments were randomly allocated in a 1:1 ratio to two groups: one receiving MTX plus HCQ, and the other receiving MTX monotherapy. We conducted a comparative analysis before and after the 12-week trial, evaluating the visual analogue scale (VAS), the disease activity score in 28 joints (DAS), serum inflammatory factor (including serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), as well as the outcome of the World Health Organization Quality of Life Brief Version questionnaire (WHOQOL-BREF) and the treatment-emergent adverse events (TEAEs) for all the participants in the study. At the 12th week of the trial, a more remarkable decrease in pain score (VAS), disease activity score (DAS), and serum inflammatory factor levels could be noticed in individuals on the combination therapy. The quality of life score was as well found to be higher in the MTX + HCQ group than the MTX monotherapy group. The incidence of adverse reactions in the MTX + HCQ and the MTX monotherapy groups were 10.00% and 6.67%, respectively. However, no statistical significance could be observed (p > .05). In our study, both the MTX + HCQ combination therapy and MTX monotherapy demonstrated improvements in symptoms, conditions and quality of life for patients with RA. Notably, the combination therapy could achieve better outcomes across all indices compared to MTX monotherapy, highlighting its potential as the optimal first-line treatment for RA. © 2024 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Clinical Effectiveness of Dienogest in the Treatment of Endometriosis

Objective: This paper aims to investigate the efficacy of desogestrel in the treatment of endometriosis. Methods: In this study, 61 patients with endometriosis in our hospital from January 2023 to December 2023 were selected and divided using the random sampling method. All the patients were treated with desogestrel and the pain symptom scores and HDL-C (high-density lipoprotein cholesterol) levels of the patients were compared before and after the treatment. The treatment effects and adverse effects during the administration of the drug were closely observed. Results: After the patients were treated with desogestrel, the effective rate of treatment was as high as 98.36%, and the incidence of adverse reactions during treatment was 6.55%. Compared with the pre-treatment period, the scores of various pain symptoms were significantly reduced and the HDL-C level was improved after treatment, with P &lt; 0.05. Conclusion: Desogestrel showed significant efficacy in the treatment of endometriosis, effectively relieving patients’ pain while elevating HDL-C levels. In addition, the incidence of adverse reactions to this drug is relatively low, which is worth utilizing.