Comparisons between different blood pressure measurement techniques in patients with chronic kidney disease

BACKGROUND: Automated office blood pressure (AOBP) machines measure blood pressure (BP) multiple times over a brief period. We aimed to compare the results of manual office blood pressure (MOBP) and AOBP methods with ambulatory BP monitoring (ABPM) in patients with chronic kidney disease (CKD). METHODS: This study was performed on 64 patients with CKD (stages 3–4). A nurse manually measured the BP on both arms using a mercury sphygmomanometer, followed by AOBP of the arm with the higher BP and then ABPM. Mean BP readings were compared by paired t test and Bland–Altman graphs. RESULTS: The mean ± standard deviation (SD) age of participants was 59.3 ± 13.6. The mean ± SD awake systolic BP obtained by ABPM was 140.2 ± 19.0 mmHg, which was lower than the MOBP and AOBP methods (156.6 ± 17.8 and 148.8 ± 18.6 mmHg, respectively; P < 0.001). The mean ± SD awake diastolic BP was 78.6 ± 13.2 mmHg by ABPM which was lower than the MOBP and AOBP methods (88.9 ± 13.2 and 84.1 ± 14.0 mmHg, respectively; P < 0.001). Using Bland–Altman graphs, MOBP systolic BP readings showed a bias of 16.4 mmHg, while AOBP measurements indicated a bias of 8.6 mmHg compared with ABPM. CONCLUSION: AOBP methods may be more reliable than MOBP methods for determining BP in patients with CKD. However, the significantly higher mean BPs recorded by AOBP method suggested that AOBPs may not be as accurate as ABPM in patients with CKD.

Comparison of negative pressure wound therapy [NPWT] and conventional wound dressings in the open fracture wounds

Objective: Successful closure is a primary step of treatment in open fracture wounds. Delayed healing or complications can lead to increased treatment duration, costs and disability rates. The aim of this study was to compare Negative Pressure Wound Therapy [NPWT] and conventional wound dressings in patients with open fracture wounds

Methods: In a prospective randomized clinical trial study, 90 patients with open fractures that were referred for treatment were enrolled between February 2013 to March 2015. Patients were divided into two groups. Group I underwent NPWT and group II underwent conventional wound dressing. Then patients were followed up for one month. Within the one month, the number of dressing change varied based on the extent of the wound. Duration of wound healing, presence of infection and the number of hospitalization days in these patients were recorded and compared at the end of the study between the two groups. Questionnaires and check lists were used to collect data. Analysis was done with SPSS 20, paired sample T-test, and chi-square tests. P<0.05 was considered significant

Results: There was a significant difference between the rate of wound healing in the group one or NPWT group and group II [conventional wound dressings] P<0.05. There was no significant difference between two groups in incidence of infection [P=0.6]

Conclusion: Using NPWT expedites the healing process of extremity wounds. It is more economical and can be considered as a substitute for the treatment of extremity wounds

Glycoconjugates distribution during developing mouse spinal cord motor organizers

The aim of this research was to study the distribution and changes of glycoconjugates particularly their terminal sugars by using lectin histochemistry during mouse spinal cord development. Formalinfixed sections of mouse embryo [10-16 fetal days] were processed for lectin histochemical method. In this study, two groups of horseradish peroxidase-labeled specific lectins were used: N-acetylgalactosamine, including Dolichos biflorus, Wisteria floribunda agglutinin [WFA], Vicia villosa, Glycine max as well as focuse-binding lectins, including tetragonolobus, Ulex europaeus, and Orange peel fungus [OFA]. All sections were counterstained with alcian blue [pH 2.5]. Our results showed that only WFA and OFA reacted strongly with the floor plate cells from early to late embryonic period of developing spinal cord. The strongest reactions were related to the 14, 15, and 16 days of tissue sections incubated with OFA and WFA lectins. The present study demonstrated that cellular and molecular differentiation of the spinal cord organizers is a wholly regulated process, and alpha-L-fucose, alpha-D-GalNAc, and alpha/beta-D-GalNAc terminal sugars play a significant role during the prenatal spinal cord development.

Case report: a case report on variation in bifurcation of brachial artery

Variations in arterial anatomy are less frequent, contrary to the venous system, and most of these variations affect visceral arteries. Variations in the brachial artery are the most frequently reported and so far a minimum of six different patterns have been described. The most common of these patterns is the superficial brachial artery, which lies superficially to the median nerve. Much less prevalent is the high origin of the radial artery [brachioradial artery] or the existence of a doubled brachial artery [accessory brachial artery]. The current study presents a pattern of brachial artery variation which was previously undescribed. During dissection of the right upper limb of a 50 year-old male embalmed cadaver, the bifurcation of the brachial artery in the proximal portion of the middle third of the arm was observed. In this case, the medial branch reaches the medial aspect of the arm, posterior to the median nerve. Afterwards, this medial branch redirects laterally and crosses the median nerve again, this time lying anterior to the nerve till it reaches the lateral aspect of the arm. At the elbow level, the medial branch originates from the radial artery. The lateral branch of the brachial artery remains lateral to the median nerve and continues as ulnar artery and originates from the interosseous artery. It was also observed that the left brachial artery was smaller in size, and bifurcated high in the arm into the superficial radial and ulnar arteries. It was also interesting to note that the common interosseous artery was originated from the left radial artery in the cubital fossa, which descended deep to pronator teres where it was divided into the anterior and posterior interosseous arteries. These variations are discussed comprehensively and compared with the previous reports. Also, it is asserted how clinically the findings are significant

Effects of chronic 5-bromo-2-deoxyuridine administration on spatial memory in the adult rats

5-Bromo-2-deoxyuridine [BrdU] has been a principal marker for mitotic cells in studies of adult neurogenesis. The method consists of a pulse injection of BrdU into the intraperitoneal cavity followed by a variable survival time allowing for tracking the divided cells and their progeny. However, such exogenous markers may produce toxic effects. Aim of this study was determined the effects of Brdu on spatial memory in the adult rat. 16 Wistar rats were used in this experimental study. The rats were randomly divided into 2 groups [N=8 in each group], as follows: control and Brdu [50 mg/kg]. Brdu was administered intraperitoneally for 6 weeks and then animals were used for behavioral testing in the Morris water maze. The data were analyzed with repeated measure's ANOVA. Our present findings show that there were no differences in the path length, escape latency and swim speed between control and Brdu-administrated groups. This study show that Brdu [exogenic proliferation marker] did not has side effects on spatial memory in the adult rats