BACKGROUND Multiple organ failure (MOF) is the main cause of death in ICUs, especially affecting septic patients. Infections are the primary outcome determinant of the MOFS in patients with septic shock. This is a prospective study conducted in DMC and H over a period of 15 months, where patients admitted to all kinds of Medicine Department ICU's were studied. The objective of this study is to provide data from our college to study the incidence of MOFS in septic shock patients, number of organs involvement and its influence on mortality. MATERIALS AND METHODS A total of 104 patients were enrolled in the study. Patients were enrolled as per inclusion criteria for septic shock. Out of total 104 patients, 64 patients (61.54%) had MOFS and 40 patients (38.46%) were without MOFS. Out of 64 patients with MOFS, 18 patients had single organ involvement with mortality rate of 11.11%, 12 patients had 2-3 organs involvement, mortality rate of 33.33% and 34 patients were having more than 3 organs involvement with highest mortality rate of 70.58%. UTI was found to be a major source of infection in 60.58% of patients. RESULTS The baseline demographic characteristics and various parameters of recovery of patients were evaluated and noted. Maximum number of patients, 29 (27.88%) were in the age group of 56-65 years followed by age group 46-55 years (22.12%). CONCLUSION So we conclude that MOF due to sepsis in an ICU is frequent with high mortality related to the number of failing organs, age and high APACHE II.
To review and summarize current affirmation on the women health consequences of premature and early menopause.We reviewed existing literature and combined results from cohort study of hysterectomy and primary ovarian insufficiency.Premature and early menopause may be either spontaneous or induced by other factors. Women who experience premature menopause (before age 40 years) or early menopause (between ages 40 and 45 years) experience an increased risk of overall mortality, cardiovascular diseases, neurological disease, psychiatric diseases, osteoporosis, and any other abnormality. The risk of adverse outcomes increases with earlier age at the time of menopause. Anyhow of the cause, women who experience hormonal menopause and estrogen deficiency before reaching the median age of natural menopause are at increased risk for morbidity and mortality. Estrogen treatment should be considered for these women, but may not eliminate all of the adverse outcomes.
Psoriasis is a chronic dermatological condition that cause scaly red patches on the different parts of body. It always tends in cycles of months wherein winter aggravation is most common then it subsides for a while then again relapse or remission. The exact identity of the factors causing psoriasis is not established but the fact that T cell activates the release of proinflammatory cytokines such as TNF-α, interferon-γ and IL-2 has been identified. Cytokine, TNF- α plays a key role in keratinocyte proliferation and other vascular changes in psoriasis. TNF-α protein levels has been found on higher side in psoriasis lesions, intraepidermal Langerhans cells and dermal dendrocytes. The available treatment options for suppressing TNF-α are given only by IV/SC route like adalimumab, infliximab and etanercept also costlier and give only symptomatic relief for a shorter period of time. Hence, we need a pharmacologically active, therapeutically safe and cost-effective agent for long term use. Against all the available data, Spironolactone an aldosterone antagonist has been found to fulfill all the necessary conditions to be used as TNF- α antagonist, a noticeable suppressive effect on TNF- α receptor along with several pro-inflammatory cytokines. Such findings encouraged beginning of clinical studies of spironolactone as TNF- 𝛼 antagonist in patients with psoriasis.
Objective: To evaluate the clinical efficacy and comparison of potassium lowering effect of insulin infusion alone and insulin infusion with salbutamol nebulization.Methods: This interventional study was conducted in a tertiary care hospital, for a period of one year. A total of 190 patients with hyperkalemia were divided into two groups. Group-A (diabetic [D] and non-diabetic [ND] patients) received salbutamol 20 mg three times daily (TDS) (nebulizer 5mg/2.5mL) administered over a period of 15 minutes with 10 units of regular insulin (diluted with 25% dextrose in non-diabetic only) over 30 minute TDS via infusion. Group-B (diabetic and non-diabetic patients) received 10 units of regular insulin (diluted with 25% dextrose in non-diabetic patients only) administered over 30 minute TDS via infusion. Potassium and glucose level was measured in patient blood sample after 0, 6, 12 and 24 hrs of treatment. Results:The potassium level was decreased by 30.09% (D) and 31.98% (ND) in Group-A, whereas by 31.98% (D) and 20.49% (ND) in Group-B, after 24 hrs. Whereas blood glucose level in diabetic patients of Group-A and Group-B was found to decrease up to 28.85 % and 40.78 % respectively after 6 hours. Both the treatments were found to be effective without any complication i.e. hypoglycaemia and hypokalaemia. Moreover, renal, liver, cardiac and respiratory function test also did not show significant changes after treatments when recorded bihourly. Conclusion:From the results, salbutamol nebulizer with insulin is more effective in the treatment of hyperkalemia in diabetic and non-diabetic patients.
The oral route is the best and most popular route for the administration of drugs in the systemic circulation. There are number of drugs which are given through the oral route. Gastro-retentive drug delivery system is very important system for the drug delivery system. The gastro-retentive drugs prolonged the drug time in the git and also improve their their bioavailability. These are widely used for site specific for the treatment of git disorders and diseases. There are number of approaches for gastro retentive drug delivery system such as floating system, mucoadhesive system, swelling system, high density system etc. In this review we discussed about approaches and various perspectives of gastro retentive drug delivery system.
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