Background: Gastroesophageal reflux disease (GERD), a fairly common ailment that has a negative influence on quality of life. 30- 40% of patients with GERD have an insufficient response to standard PPIs therapy. For subjects resistant to this PPI therapy, double the PPI dosage or switch to different PPIs, which may not be ideal. So, combination therapy with prokinetic agent will significantly improve GERD symptoms. Study Design: A prospective observational study. Place and Duration: In the Department of Medicine, Faisalabad Medical University, Faisalabad from May 2022 to July 2022. Material and methods: 130 patients with suggestive symptoms of GERD were included to evaluate overlap between GERD and delayed gastric emptying and to forecast the necessity for therapy in combination with prokinetic drugs using the Frequency Scale for the Symptoms of GERD (FSSG) score. Results: 17.20 ± 8.40 was the mean total score of FSSG. Of the 130 subjects, 106 (81.54%) patients have GERD symptoms with an overall FSSG score >8. 7.43 ± 4.08 was the mean reflux score, and 9.40 ± 5.30 was the mean dysmotility score. In this analysis, patients with GERD symptoms had high score of FSSG, the symptoms of dysmotility appeared to be the main symptom than acid reflux. Conclusions: Based on this analysis results, combination therapy with prokinetic and PPIs in the subgroups of subjects with high scores of FSSG improved GERD symptoms. Keywords: Dysmotility score, delayed gastric emptying, GERD and Reflux score.
Background: The infection of HCV is recognized worldwide as an important community health problem. There is an optimistic correlation between accumulation of iron in hepatocytes and amplified serum levels of markers, counting ferritin and transferrin. Aim: The goal of this study is to determine the response of serum levels of ferritin after the patient’s treatment with HCV infection. Material and methods: The study included 140 HCV-infected patients. All subjects were evaluated for clinical topographies, including HCV viral load, status of serum iron levels and biochemical data. The obtained outcomes were calculated by means of Microsoft Excel 2013. Results: The results showed that treatment with antiviral drugs interfered significantly the iron deposition in hepatocytes and have association between iron accumulation and HCV treatment. The mean iron value was 20.02 µmol / L for the positive PCR patients; and for a negative PCR reaction, 25.11 µmol / L was the estimated value before treatment. Both values were lower the normal array of 9-31.3 µmol / L. It is estimated that the mean ferritin value for negative PCR (668.55 µmol / L) and positive PCR (913.14 µmol / L) is above normal range which is 221 to 641.35 µmol / L. Conclusions: Patients with chronic HCV are significantly related to serum iron levels. High levels of iron and ferritin were associated significantly with the disease, resulting progressive fibrosis in the liver. There is no considerable change in serum iron markers among subjects with increased or less severity of HCV infection. The severity of the disease can be evaluated easily by measuring the serum transferrin levels along with ferritin levels, which are linked with the progression of fibrosis of the liver and necro-inflammatory activity. Keywords: levels of serum ferritin; iron load; drug; liver cells and HCV infection.
Background: Maternal skin contact has impact on physiological parameters in newborns, some studies showed positive effects but as we live in under developing country and the data on impact of kangaroo mother care (KMC) on physiological parameters is very limited. We hypothesized that KMC is effective in stabilizing the heart rate, respiratory rate and maintaining the oxygen saturation and body temperature of low birth weight (LBW) newborns. Objective: The aim of the study was to determine effects of 3 hours KMC on physiological parameters such as body temperature, heart rate, respiratory rate and oxygen saturation in LBW neonates. Study Design: Observational Quasi-experimental study Study Setting: This study was conducted in Department of Neonatology, Children Hospital, PIMS, Islamabad, Pakistan from 1st June 2022 to 1st December 2022. Methodology: The neonates were hemodynamically stable admitted in NICU and Nursery of Children Hospital, PIMS with LBW with the bodyweight <2 kg was enrolled in the study after taking the consents from mother or other female attendant. Data were collected by structured questionnaire and observational checklist after taking consent from each participant. After inclusion neonates was received KMC for 03 hours. Participants physiological parameters were monitored closely before and after KMC. The statistical analysis was done by using SPSS version 20. Results: Out of the 60 mother-child couples enrolled in the study. There was high frequency of neonates between 1-1.5 kgs with 36.7%. Out of 60, 33 were baby boys and 27 were baby girls. After three hours of KMC, temperatures showed significant increased (p<0.001). Most infants' temperatures were maintained during KMC, and no cases of hypothermia were reported. Also, statistically significant increases in heart rate were seen throughout KMC (p<0.001), with mean increases of exhibited bradycardia before starting KMC, but at the end of the session, all of their heart rates were normal (100-170 beats per minute) and stable. Practical implications Though KMC has been proven to be an efficient and feasible approach of caring for LBW infants in a hospital setting, there is a lack of evidence on its outcomes in Pakistan. In light of this, we set out to examine the impact of 3 hours of KMC on vital signs in LBW infants, namely their core temperature, heart rate, respiratory rate, and oxygen saturation. The ultimate goal is to collect enough evidence to advocate for the strategy's widespread adoption. Conclusion: Better quality and more humanized care for preterm and low birth weight babies and their mothers may be achieved by encouraging the use of the Kangaroo Mother Care approach in neonatal intensive care units in Pakistan. Keyword: KMC, temperature, oxygen saturation, respiratory rate, heart rate. Low birth weight
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