1. The process of pulmonary ventilation and gas exchange was investigated in twenty-three young patients with chronic severe anaemia, before and after its correction. 2. Various lung volumes, pulmonary mechanics, minute ventilation, oxygen consumption and carbon dioxide production were found to be normal in anaemic patients. 3. There was a mild respiratory alkalosis in anaemia. The arterial oxygen tension was lowered because of a marked widening of the alveolar-arterial oxygen tension gradient. This was mainly because of an increase in the anatomical shunt as well as ventilation/perfusion inequalities. 4. The transfer factor (pulmonary diffusing capacity) in anaemia was very much reduced. The diffusing capacity of the alveolar capillary membrane was usually decreased and volume of blood in the alveolar capillaries usually increased but these changes were not statistically significant.
Background: For patients with atrial fibrillation who are at high risk for bleeding or who cannot tolerate oral anticoagulation, left atrial appendage (LAA) closure represents an alternative therapy for reducing risk for thromboembolic events.Objectives: To compare the efficacy and safety of the Amplatzer and Watchman TM LAA closure devices.Methods: A meta-analysis was performed of studies comparing the safety and efficacy outcomes of the two devices. The Newcastle-Ottawa Scale was used to appraise study quality.Results: Six studies encompassing 614 patients were included in the meta-analysis. Overall event rates were low for both devices. No significant differences between the devices were found in safety outcomes (i.e., pericardial effusion, cardiac tamponade, device embolization, air embolism, and vascular complications) or in the rates of all-cause mortality, cardiac death, stroke/transient ischemic attack, or device-related thrombosis. The total bleeding rate was significantly lower in the Watchman TM group (Log OR = −0.90; 95% CI = −1.76 to −0.04; p = 0.04), yet no significant differences was found when the bleeding rate was categorized into major and minor bleeding. Total peridevice leakage rate and insignificant peridevice leakage rate were significantly higher in the Watchman TM group (Log OR = 1.32; 95% CI = 0.76 to 1.87; p < 0.01 and Log OR = 1.11; 95% CI = 0.50 to 1.72; p < 0.01, respectively). However, significant peridevice leakages were similar in both the devices. Conclusions:The LAA closure devices had low complication rates and low event rates. Efficacy and safety were similar between the systems, except for a higher percentage of insignificant peridevice leakages in the Watchman TM group.Basu Ray et al. Meta-Analysis Comparing Amplatzer With Watchman TMA randomized controlled trial comparing both devices is underway, which may provide more insight on the safety and efficacy outcomes comparison of the devices.
Context: Elderly have increased frequency of awakenings of longer durations, lower sleep efficiency, early bedtimes and wake times as compared to younger subjects. The study was conducted to assess the quality of sleep using Pittsburgh Sleep Quality Index (PSQI), sleeping habits and changing sleep pattern among elderly and their associated factors. Material and Methods: A cross-sectional study was conducted for a period of 3 months among all the elderly population residing in village Thano situated in Raipur block of district Dehradun, Uttarakhand. A total of 96 elderly were surveyed. Data was collected on sociodemographic characters of elderly as well as questions on Quality of sleep was asked based on PSQI questionnaire. Data was collected using Epi-collect5 application on phone. Data was analysed and presented utilizing appropriate statistical methods. Results: Among the 96 elderly, 57.3% of the participants were females and 40.6% were from 60-69-year age group. The mean PSQI score was 5.6±1.9. Sleep quality was poor among females, smokers, widow and those with no physical activity. With advancing age sleep quality came out to be significantly poor. Conclusions: Sleep disturbances are commonly seen among the elderly. Treatment of primary sleep problems can improve the quality of life.
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