The aim of this meta-analysis was to assess the effectiveness of acetazolamide as an add-on diuretic therapy in patients with heart failure. This meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. A systematic literature search was independently performed by two authors using MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews to identify relevant studies assessing the use of acetazolamide in patients with heart failure. The search keywords included "acetazolamide" and "heart failure". The outcomes assessed in this meta-analysis included natriuresis (mmol/L), diuresis (Liters) and decongestion (absence of signs of volume overload) by 72 hours. Other outcomes assessed in this meta-analysis included hospitalization due to heart failure and all-cause mortality. A total of three studies included a total of 569 heart failure patients. The number of patients achieved decongestion was significantly higher in patients receiving acetazolamide compared to the patients randomized in the control group (RR: 1.34, 95% CI: 1.06-1.67). Compared to patients in the control group, mean natriuresis was significantly higher in acetazolamide patients (MD: 74.91, 95% CI: 39.85-109.97). Diuresis was significantly higher in patients receiving acetazolamide compared to the control group (MD: 0.44, 95% CI: 0.16-0.72). No significant difference was found between the two groups in terms of all-cause mortality and hospitalization due to heart failure. In conclusion, our metaanalysis suggests that acetazolamide may have beneficial impacts on heart failure patients by increasing the number of successful decongestions. Additionally, patients who were treated with acetazolamide had significantly higher natriuresis and diuresis compared to patients in the control group.
Aim: In order to manage discomfort and increase range of motion, this study compared the effectiveness of static stretching versus the hold-relax approach on hamstring flexibility. Study design: The study design was Randomized Controlled Trial (RCT). Place & duration: This study was conducted in Physiotherapy Department and Rehabilitation center at Mayo Hospital Lahore.The duration of study was 4 months after approval of synopsis. Methodology: In ‘group A’ Static stretching is applied while in ‘group B’ Hold Relax technique of PNF was applied, while in ‘group C’ conventional physiotherapy was applied. Allocation of patients in two groups had done by computerized generated list. All groups will also receive conventional therapy, which will remain same throughout the study. The conventional therapy will include: Heating pad for 15 minutes, Hamstring isometric exercises, Ankle pumps exercise, Hamstring self-stretches [toe touching while standing or long sitting].Group A will receive static stretching for hamstring muscles while group B will receive PNF hold relax technique, group C will be benefited by the conventional physiotherapy. Treatment frequency will be 3 times a week. The duration of treatment will be 2 weeks in both groups. Results: Pair 1 had shown that the pre and post treatment comparison of Numeric pain rating scale mean score of pair 1 of group A before treatment was 7.5±1.083 which improved to 5.5±1.56. Pre and post treatment comparison of pair 2 of group B had showed that mean score before treatment was 7.6± 1.23 which was improved to 2.2±1.48. Pair 3 of group C improved from 8.3±0.778 to 4.8±1.02. Conclusion: The findings of this study led to the conclusion that static stretching is superior to the hold-relax strategy for treating hamstring stiffness. It lessens pain and enhances muscle function and flexibility. Keywords: Hold relax technique, hamstrings flexibility, static stretching
Often impacting elderly women, the urinary incontinence is defined as the involuntary urine loss. Objective: The purpose of this study was to see the comparative effectiveness of pelvic floor muscle exercise with pilates training for treatment of urinary incontinence. Methods: The study's 36 patients who met the eligibility requirements were accepted. Prior to conducting any examinations, we obtained written informed consents from each participant. Patients with urinary incontinence were divided randomly into two groups. In ‘group A’ pelvic floor muscle exercises were applied while in ‘group B’ pilates training was applied. Allocation of patients in two groups was done by computerised generated list. Both groups received conventional therapy, which was the same throughout the study. The conventional therapy includes adductor strengthening of thigh and hot pack for 15 minutes. Group A received conventional therapy and pelvic floor muscle exercise while group B received conventional therapy and pilates training. Treatment frequency was 2 times a week. The duration of treatment was 6 weeks in both groups. Each patient's informed consent was obtained before the questionnaire was filled out. Scores were derived using the Questionnaire for Female Urinary Incontinence Diagnosis (QUID) and the International Consultation on Incontinence Questionnaire (ICIQ). Results: Patients in group A significantly outperformed those in group B. Conclusion: According to the study's findings, strengthening the pelvic floor muscles is superior than practicing pilates for treating stress urine incontinence. Pelvic floor exercises not only improved the urine leakage problem but also strengthened the muscle of abdomen and pelvis. So these exercises programs should be included in treatment plans along with medications in public health care for the welfare of patients.
Sickle cell disease (SCD) is a genetic hereditary blood disease that disrupts normal beta-globin production. Patients with SCD experience a broad range of symptoms ranging from anemia, pain crises, and jaundice to acute coronary syndrome and stroke. SCD has been treated with hydroxyurea since 1998. Three important pharmacotherapies have been approved by the Food and Drug Administration (FDA) in the past few years. L-Glutamine has shown efficacy in reducing vaso-occlusive pain crises and hospitalization. Crizanlizumab has also shown positive outcomes in patients with SCD. Voxelotor has been studied to be effective in improving hemolytic anemia and the quality of life in SCD patients. These drugs can be used alone or in conjunction with hydroxyurea. Trials have shown that these therapies have significant efficacy. The events of pain, hemolytic anemia, vaso-occlusive crises, and hospitalizations have been reduced by using these agents. In this editorial, we will discuss these advanced treatment options for patients with SCD.
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